51001.3z a
W 2
n OR PLUMBING PERMIT
ff�V C:�"q} F CUPERTINO
f SEP 11 ,gE8 p sanitary No.
Date 19' �% , 1962 Permit N
-:r—i 0 0 / .4
CITY. OF C�UPE�iT��Q Fee S 21,00
Application is here y ma e t 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
Cupertino, and all other laws applicable thereto.
Use of Premises _k 4� , r'�, �Q
Owner ��^/ 46-aWddre(`/'�//���`p���r�
By AddreS�
CONTRACTOR. AGENT /
Phone A f 2400 7
State Licensea'�'? 9 3.i
,ed 1
'?C PLUMBING INSPECTOR
�r//(/'�
7
9
�
„ry LOT NO.
NO.
TREF.T
z a
W 2
n OR PLUMBING PERMIT
ff�V C:�"q} F CUPERTINO
f SEP 11 ,gE8 p sanitary No.
Date 19' �% , 1962 Permit N
-:r—i 0 0 / .4
CITY. OF C�UPE�iT��Q Fee S 21,00
Application is here y ma e t 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
Cupertino, and all other laws applicable thereto.
Use of Premises _k 4� , r'�, �Q
Owner ��^/ 46-aWddre(`/'�//���`p���r�
By AddreS�
CONTRACTOR. AGENT /
Phone A f 2400 7
State Licensea'�'? 9 3.i
,ed 1
'?C PLUMBING INSPECTOR
FIXTURES I NUMBER 11 MAIN DRAIN
UNITSI FEES _ , UNITS
Water Closet I 1 1 11 Material`)./.
Shower
Kitchen Sink /1 11 Not Conn.
Dish Washer Sewer Box
Waste Dispo
me
Comb.Sink&Tray I 1 11 To Curb
Drinking Fountain
Floor Drain
WATER SYSTEM
Hopper
Size
Restaurant Sink
Material /,V.
Send Trap
TOTAL FEES
Urinal
Fixture Fee
Area Drain
Main Drain Fee _
Water Leader
Storm Drain Fee
Sprinkler Valve
Water Sys. Fee
Relief Valve
Gas Fee
Vac Breaker
Skimmer
Filter
Permit Fee . G�
Total
Total Fee