51099.1 10313 I Degas Court LOT NO, 24
NO. STREET
f.;nPgN FOR PLUMBING PERMIT
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zY OF CUPERTINO
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, 0 qq (ry� Sanitary No.
o ' Dated oecetn11Y77, 19f>x10 Permit No
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oif ycatofis GAR e 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
aw Cupertino, and all other laws applicable thereto.
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w Use of Premises Duplex
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3 Owner Perrotti Construction Co. Address 2225 Grant Rd. ,L'os2AItos
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z By W. L. HICKEY SONS, INC. Address 190 Commercial, Sunnyvale
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— < Phone 736-4938
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ao State License. 95122 Approve
IX PLUMBING INSPECTOR
FIXTURES NUMBER MAIN DRAIN
Units Fees Units Fees
Water Heater Size
Water Closet 16,6011 Material
Bath Tub .D To Cur
Shower To Prop. Line
Lavatories To Exist
Kitch n Sink Not Conn.
Dish Washer
Waste Disposal z ,p
Wash Tray STORM DRAINAGE
Washing Machine Size
Water Softener I Material
Bar Sink I To Main Drain
Comb.Sink&Tray To Curb
Dental Unit
Drinking Fountain
Floor Drain WATER SYSTEM
Hopper Size
Restaurant Sink Material
Sand Trap TO AL FEES
Urinal Fixtur Fee lJ�
Area Drain Main Drain Fee D
Water Leader Storm Drain Fee
Sprinkler System Water Sys. Fee v
Relief Valve Gnq Fee,—
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Vac Breaker
Skimmer
Filter
Pool Sweeper
Permit Fee —200
Total Total Fee