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z < APPLICATION FOR PLUMBING PERMIT
r MAY 13 1971 Sanitary No.
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o a Date 97-/ Permit No. e�
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� Application is hereby made to the City of Cupertino for a permit to install Plumbing
o a pipes and/or fixtures listed on the reverse side hereof, and agrees to install said prices
> I and/or fixtures in accordance with the provisions of the Plumbing Code of the City of
a w Cupertino, and all other laws ap>licable thereto.
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w Use of Premises
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� 3 Owner
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By A;,be f timer
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CQ+#:F AGENT
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Addressia7) Amu lai -'?) -
Address I 1 1,
Approved WILLIA"A D. BENEVICH
PLUMBING INSPECTOR
Units
Wash
Floor
Total
Size
To Curb
Material
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NW OF €-ift6ftt Lot No.
MAY 3 1971 APPLICATION FOR PLUMBING PERMIT
P D CITY OF CUPERTINO
Sanitary No.
Date „ 1 &71 ,196-1
Permit No. -S \ 1 'V
Fee S S'
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 Cupertino, and all other
laws applicable thereto.
Use of Premises
Owner�gCQ JA1Lmg1Z Addresst'm6'171 l wlv-" t>k
By(fjaOVQ,&.Nj \ Ft -L -S AddresseS�
Contractor, pAgent
Phone !�� % '- X 119
State License �y`J q �lQ ApproveOr d
Plumbing Inspector
FIXTURES
NUMBER MAIN DRAIN
Units Fees Units I Fees
Water Heater
Size
Water Closet
Material
Bath Tub
To Curb
Shower
To Prop. Line
Lavatories
To Existing
Kitchen Sink
Not Conn.
Dish Washer
Waste Disposal
Wash Tray
STORM DRAINAGE
Washing Machine
Size
Water Softener
Material
Bar Sink
To Main Drain
Comb.Sink & Tray
To Curb
Dental Unit
Drinking Fountain
Floor Drain
WATER SYSTEM
Hopper
Size
Restaurant Sink
Material
Sand Trap
TOTAL FEES
Urinal
Fixture Fee
Area Drain
Main Drain Fee
Water Leader
Stom Drain Fee
Sprinkler System
Water Sys. Fee
Relief Valve
Gaq Fee-S�
Vac Breaker
Skimmer
Filter
Permit Fee
Total
Total Fee 1'0