1433 (2) LOT NO.
NO. S=T
�LISVI FOR PLUMBING PERMIT
I = . OF CUPERTINO
Date '��'A' 6 1962 i "
195— Permit No.
11
CITY Cr C!IPEgfl� Fee$ /9
Application Is hereby ma a to a City of Cupertino for a permitof install plumbing
pipes and/or fixtures Listed on the reverse side hereof, and agrees to install said prices
�1 and/or fixtures in accordance with the provisions of the Plumbing Code of the City of
V Cupertino, and all other laws applicable thereto.
w Use of PremiOa/ .//oma � o
:a
0
Owner—cc%s A i���-Address
ByP ,_ Address
k7oo��CONIAACfOA, AGENT
1 � hone �- /// Approve
P116111BING INSPECTOR
ry� ...
7rTKru-RES —NUMBER MAIN DRAIN fj
�^ UNITS FEES F �,UNITSI FEES
Water Heater / j jl Size /V//
later CI-)Sets Material es,y
th Tubs j / jj To
HaCurb
Showers To Prop. Line
Lavatories 1 11 To Existing j a
Kitchen Sinks i
Dish Washers
Waste Disposals
Wasli'�Trays j / j jj STORM DRAINAGE p
Washing Machines j j� Size j
Water Softeners Material j
Har Sinks j j 11 To Main Drain j
Comb. Sink &TraysTo Curb
Dental Units
Drinking Fountains] jl j
Floor Drains WATER SYSTEM
Hoppers Size 3 y j__ E
-Restaurant Sinks j � Material,#,.& j j f
Sand Traps j jj TOTAL FEES F
Urinals Fixture Fee
Area Drains j j� Main Drain Fee j �, a
`Water Leaders j j� Storm Drain Fee j
Sprinkler Vaives I I jl Water Sys. Fee j f. a Qi
�oi,WA �n-a/ / j2..5O jj permit Fee r /, O d
:;TOTAL j/�,�/pj TOTAL FEE
R CO ,F� IN EC_TION
,Partial Rough ,3�
Rough Complete _
'Final {
1
W
V o z z
LL � �
y O a eco
� a
z
W
z �
o i c c
w
❑ d F A A