51001.2.Z2 35 -z I /34 A I S)z LOT NO.
NO. STRF. F.I'
® A=P CN1FOR PLUMBING PERMIT
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zCITY OP CUPERTINO /
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r o I ��U r) �(�,60 �� Sanitary Nu.
51001. 2-
o Date f96 Permit No
3a
W W Y� OF �I p[ � p1n
Pee $
o Application isrher@tS}�htddRtblt7iN City of Cupertino for a permit to install plumbing
o 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
a w Cupertino, and all other laws applicable thereto.
W x
W Use of Premises
o_o
> N �n
3 Owner .J N G—
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z y
B
O CONTRACTOR, AGENT
3 `m Phone
.ie / L
s License
0
Address Z 3J sr
Address 17G/ ~
'J Y"J
Approved
PLUMBING INSPECTOR - AOV
FIXTURES NUITMBER �� MAIN DRAIN
UNS FEES UNITS
Water
Kitchen *ink
Dish Washer
ine
To
Comb.Sink&Tray I 1 11 To Curb
Floor Drain WATER SYSTEM
Hopper Size I
TOTAL
ee
Water Leader
Relief Valve
I I II Permit Fee 1 .2. to
Total
;? 5 s2z I LOT
No. - STILEBT
APPLICATION FOR PLUMBING
'r �fi .i 68 CITY OF CUPERTINO
PERMIT
Date 641� /D 196x0 Permit No. Sid O /"Z
Fee $ oj: 6T
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
Address 22 � A
Address0 Gs�Cc� l
Approved. — • . /
PLUMBING INSPECTOR/Ig
FIXTURES NUMBER MAIN DRAIN
UNITS FEES
UNITS FEES
Water Heater I II Size
Material
Water Closets Material
To Main Drain
Bath Tubs To Curb
To Curb
Showers To Prop. Line
WATER SYSTEM
Lavatories To Existing
Size
Kitchen Sinks Not Conn.
Material
Dish Washers
TOTAL FEES
Waste Disposals
Fixture Fee
\YJ6 TCTnDXC nD A7MACU
II
Washing Machines 1 II
Size
Water Softeners
Material
,Bar Sinks
To Main Drain
Comb. Sink & Traysl I II
Dental Units I I I
Drinking Fountainsl III
To Curb
Floor Drains
WATER SYSTEM
Hoppers
Size
Restaurant Sinks
Material
Sand Traps
TOTAL FEES
Urinals I u
Fixture Fee
Area Drain
II
Main Drain Fee l
Water Leaders
Storm Drain Fee
Sprinkler Valves
Water Sys. Fee
II
Permit Fee
TOTAL ,��
TOTAL FEE
RECORD OF INSPECTION