1430 (2) 11 L
�O.�d ofle[ /�l,/f LOT NO, 1-2
N4. STREET
FOR PLUMBING PERMIT
�r ���q ITY OF CUPERTINO
Date fy11.PR 6
195_ Permit No. J J
�l
' CITY OF CUPERTINO FeeB
App icahon 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
G Cupertino, and all other laws applicable thereto.
u
� o
L_' Use of Premises
:a
v
y Owner�ud%� tom` � Address �,• �o f n
By r o Address
O CTOR AGENT
one FiP- 111 Approve
I PhPL IEN1 INSPECTOR
"77
MO
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,UNITS I FRES -A JIUNITSIFEES
Ntze
afe rj:H eat i,
�'Water 70—i'lctsll Material`
aff'juk"s 11 TO Curb—11-- -1
'hO'.'ki is To Prop Line
-11
bb vtkt9b r il e—11, To Existing 4,
,
4—
gR�
Kitchen Sinks 1 11 NorConn.
ulio
PWaste Disposals l
�
rays STORM DRAINAGE
Washing:-
T , Machines 'I ize
WW�tners I 1 11 Material
Bil;Sinks
To Mai in
Comb id &Tr ysl
To Cue
Dental
Units
D-H i A Fountainsl I P 1
?:jbor Drains WATER SYSTEM
Hoppers Size
RestauraInf!S_ Material
TOTAL FEES'I'- 1,
Fixture 471-
ell
Main
Water Leaders �� stormiDraiptFcc
Water"Sys.-fcc
I pbralit, Fee
&TVQjTAL TOTAL FEE- Sat.
�ECORIJ bpNs CTION
4
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