100167 /2-:?4 I —.'
LOT NO.
NO. J D ET
74P LICATI OR PLUMBING PERMIT
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INIAR A 1368CI I`�ie cuPeaTlNo
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Sanitary No.
3 a Uate H / -�pl�t`tt Permit No. Za dr /b 7
Pee $
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Application is hereby made to the 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.
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Use of Premises ?6 0 L q v/G.An4i-Al
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r 3 Owner (al S/Cyfj Address 1/x34 A641-4d 2D
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z By Address
0 CONTRACTOR, AGENT
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a o State License -rr�C_ Approv d
-V- PLUMBING INSPECTOR /
FIXTURES NUMBER MAIN DRAIN
UNITS FEES UNITS FEES
Water Heater I Size
Water Closet Material
Bath Tub To Curb
Shower To Prop. Line
Lavatories To Existin
Kitchen 5ink Not Conn.
Dish Washer Sewer Box
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 Storm Drain Fee
S rinkler Valve Water Sys.Fee
Relief Valve /S Gas Fee /
Vac Breaker
Skimmer /3
Filter / s
Permit Fee o;L
Total 3 _ Total Fee p—o
1�° B"'W'TU OI l7. LOT NO.
�y NO. STREET
W ¢ ?17fe�le�ly
PP11TI rR BUILDING PERMIT
a ° C CUPF.RTINO
° j R 4 6aSanitary No.
50Date Permit No. /cJ f / 7
ro
OQ Appfi1ai iOn i111�,EICUV pQvrtn t to <'i.,,OfAw 14 i 1�ooc-
i U) a story,Type301,E Building
W to be occupied only as in accordance with
o 'o Plans, Specifications and Plot-Plan filed here h. PI Ck Fee
Estimated Value of Improvements, $.:e� O O P� Fee$
iJ It is hereby agreed that the requirements of the Cupertino Building and Zoning Ordinances and '..
J z all other laws applicable to the constriction,-location, and use of buildings within the City of
o Cupertino will be complied with.
PIN
_ m Owner
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_U Phon �y_ �b 1 D Approv
State LicensC B DING INSPECTOR