1424 (2) p 0 0
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0 LOTNO.
NO. S
R PLUMBING PERMIT `
•( i ERTINO
t�l�..: 6 i9�
I!i Date 195_ Permit No.
CITY OF CUPERTINO pee$ /9, sn
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
V Cupertino, and all other laws applicable thereto.
v
� o
8 Use of Premises
v
Add
Owner
o
Address � ��L�%
0
By AddresC "I s
CONTRACTOR, AGENT B
phone /l/ Approv
PLUMBING IN111CTOR
URES �BERD
MAIIN JLAIN
I UNITS I FEES -- I UNITS 1 FEES
/1
,Water,Heater Site V
Material 17
'W---7CF
(!. .�
I ath':T' bs To Curb
Sh- em 10 Prop. Line
,Lavatories To Existiri
,&itichen Sinks No - n
Dish Washers
Waste Disposals
as � rays STORM DRAINAGE
;Washing
te _Nfachisnes-1— ISite d
a -Softeners
Material
Bar Sinks To Main Dra.inJ
To Curb
,.,c, b.,Sinlc &Trays
Dental
Drinking Fountains--
�'Floor Drains WATER SYSTEM
Hoppers
eria1 ,8L,&,/
estTu+rant-S—inks
TOTAL r,YLLN
Urinals Fixture—Fee
'- ea Drains ffr—ain,., Main Drain Fee, 0
`W, AtcT Leaders Storm Dram 1-ce
,Srtmkl,, Na,,es Water Sys. Fee ' 6P
`'tea aie _46 11 Permit Fee /, 00.
;TOTAL 114..5oll I OTAL TEE /r9 ,s'0
VC RD 0 IN E ION
Mrt'ial Rough a .2-
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