1884 (2) / 0 LOT NO. V
NO. T
R PLUMBING PERMIT
s CITY OF CUPERTINO
x o ��DEC 17 1962 �' Sanitary No.
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0 'a Date 196_ Permit No
3 CITY Of CUPERTINO Fee $
0 Application is hereby made to the City of Cupertino for a permit to install plumbing
o a 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
wCupertino, and all other laws a licable thereto
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LL Use of Premises
00
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3 Owne Address/ .
2 0 y Address— N Phone
ao State License U C/ OZsj Approved
_U CONTNACTOR, Af,F.NT
-FIXTURES NUMBER - MAIN DRAIN _
_ UNITS FISISS J.� FEIS
Wnrer Hencer , Size
Water C osets Material
Bath Tubs SI To Curb
Showers To Prop. Line
Lavatories To Existing
Kite ien� Sinks — Not Conn.
Dish Washers Sewe IIoxe
Waste Disposals
\`Dash Trays � STOR DRAINAGE
\Y/as a"ng Machines ( Size
Water Softeners Material
Isar Sinks To Main Drain
Comb. Sink s Trays To Curb
Dental Unity''
Drin ing Fountains
Tr Drains WATER SY T -M _
Illers Size
Restaurant Sinks Material
San raps TOTAL FEES
Urinals PS
ixture Fee 0, 0''d
Area rains Main Drain Fee �Jp
Water Leaders torm Drain Fee
Sprinkler Valves Wate[ Sys. Fee . D"
Permit Fee .B U
' TOTAL p,(gyp TOTAL FEE
.9�
ground Rough. o _
.Partial Rough..
.Rough. Complete..
A4ain Drain
Final... 2 —
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