1499 (2) /a JP C; /iICYIBLBb Q/I/l Lr LOT NO. d/
NO. STREET
R PLUMBING PERMIT
C F CUPERTINO
?fAPR 7 1962
Date 0/7/[ /Z 198� Permit No. � '7
CITY OF CUPERTINO Fees
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.
L Use of Premises �i�S/Oe Nce
'a
u
N Owner G/iArnrinio P//oAr�T/v� Address At o,
By—t�L71;—;//Z
a Address Ca�OAi<a
,7, Phone Approve
PLUMBING INSPEC[OR
URNS NUMBER MAIN
UNITS I FEES NITS ftP.ES
-Water Heater I / Size qa
'Water Closets Material c I
Ba h 'rubs To Curb
wcrs To Prop. Line/
T
aa_,vaCones To Existing
'itchen Sinks I �j N Goono
Dii h Washers
-. Disposals
VUasl "I'nys �_/ ��� STORM DRAINAGE
*Washing Machines 1 1I Size
�Watee Softeners �� Material
: it Sinks-, To Main Drain
,'Comb, Sink a'TraysTo Curb
,f0-cnial-Units
iDDrinking Fountains)
(floor' Drains . WATER SYSTEM
Poppers I-�Pp � � � Size ?
I Resta4rant Sinks Material 6n� ✓,
f"Sand Traps TOTAL FEES
Urinals Fixture Fee //. p J
�Area Drains � � ��� Main Drain Fee � �,oy
Water Leaders I Tj Storm Drain Fee '
rin ler Vai a Water Sys. Fee
11 Permit Fee
TOTAL 11 TOTAL TEE /Cj,o ci
R °C• RDOE
.N_4PECTION
rr.a tial Rough _
RoGgh Cor e '
itFinal
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