1244 (2) LOT NO. 57 ,
NO.
R PLUMBING PERMIT .�,
IFSEP26161
CI CUPERTINO S
;. Date 195_ Permit No.
CITY OF UPERTINO __`L;
� Fee $
N Application is hereby made to the City of Cupertino for a permit to install plumbing
pipes and/or fixtures listed on the reverse side hereof, and agrees to install said prices
M and/or fixtures in accordance with the provisions of the Plumbing_Code,of the City of
�j Cupertino, and all'other laws applicable thereto. A
j 8 Use of Premises � 'e
v o
N Owner(o»,m+�.�„ �._.t.,��I�Q��Q�/_a�Address +,
By Address
'I �/^�� CONTRACTOR, AGEN
J e,/Phone ///. Approved
`-r PLUMBING INMCTO
SURES NUMBER MAIN DRAIN
UNITS FEES 11- 1 J UNITS 1 FEES
Water Heater Size ' I [/"
W---r. C;osets i a Material z C.-TI
Bath ';-'"' / - R II To Curb •-'-�A
Showers / " To: Prop. Line!'I t/' I
Lavatories T To Existing
Kitchen Sinks
Dish Washers
Waste Disposals Z
Wash Trays . ' STORMDRAINAGE
Washing Machines / - I 'Size 0 , �:-J f .'
Water Softeners 11 Material
Bar Sinks: _ II To Main Drain;I I.
comb.-sink a Traysl To Curb_- ! I
DentalUnits: „ 'I
Drihkingoti
Fntainsl �� _ I 't � ..,4 - ,
Floor Drains WATER.SYSTEM t
Hoppers ,Size )
Restaurant Sinks 11 .Material y1 `_J 'Wafyl
Sand Traps II }TOTAL(FEES
Urinals Pizture?Pee ("t' 1g,-3-0
Area Drains Main Drriiin e •. /.00
Water Leaders 11 .Storm:pfKtia-'-!Fite
Sprinkler Valves I II Waterj§y3NFee ,1 /.00
�lo�.,P� .B,m/ asO PeiinitiFee�' � /-00
TOTAL - TOTAL^FEE .SO
R
Copp O CTIONT
Partial Rough f1 y1
Rough Couw.te "• 5 ?'1
Final ,.
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BUILDING 'INSPECTOR'S OFFICE# '
CITY O0CUPERT_INO-•
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