1906 (2) LOT NO. �,9
ao. Tx
RAPPL`ICATI? FOR PLUMBING PERMIT
Jill . .
JAN 7 1353 ��-, " CUPER '
Date 3 19!5 3 Permit No.
Vr CITY C:; (''`KRTIN Fee $ /9
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
and/or fixtures in accordance with the provisions of the Plumbing Code of the City of
Cupertino, and all other laws applicable thereto.
Use of Premise�.���
y Ownealrr,. A AddresSP#LUIMIG
Addres 'z ✓YCONT CTOA. AGENTPhon ^� `�L '"a5�ri!r ik it � APprovPE a
URES NUMBER MA I
I UNITS I FEES Ir UNITS FEES
Water Heater Size
Water Closets Material C
Bath Tubs I / I II To Curb
Showers I /, I II To Prop. Line
Lavatories 13 I To Existin
Kitchen Sinks I k6t,Con
Dish Washers I SEWtA BOXES �• �-
Waste Disposals I I
Wash Trays I I I� STORM DRAINAGE
Washing Machines II Size I I
Water Softeners Material I I
Bar Sinks I I II To Main Drain
Comb. Sink a Trays) II To Curb
Dental Units I _
Drinking Fountains)
Floor Drains I I WATER SYSTEM _
Hoppers _ I I lmat I�_
Restaurant Sinks I I :Material I
Sand Traps I II TOTAL FEES
Urinals I I Fixture Fee , 1 -
Area 6—rainsl I II Main Draih Fee„I z
Water Leaders Storm Drain Fee
Sprinkler Valves I Water Sys. Fee „ , t
Permit Fee ,r r
TOTAL I I TOTAL FEE lam, t t
RECORD O SP Q N t
Partial Rough — _?
Rough Co e e _
Final _ _