51099.1 10333 I Degas Court LOT NO. 25
NO. STR E R.a'
AP LICATION FOR PLUMBING PERMIT
-,wz aQTl' OF CUPIiRTINO
r o Sanitary No.
0 a D e _ e 7 19 70 Permit No. .S�LL�LL99
W LL Fee $ TA•dw
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I the City of Cupertino for a permit to install plumbing
`o �j0an Ii e reverse side hereof, and agrees to install said prices
11- 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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LL Use of Premises Duplex
00
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, Owner Perrotti Construction Co. Address2225 Grant Rd. ,Los Altos
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By W. L. HICKEY SONS, INC. Address190 Commercial, Sunnyvale
J CONTRACTOR, AGENT
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- Phone 736-4938
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s95122
Q 0 State License Approved
— 0 PLUMBING INSPECTOR /
FIXTURES NUMBER MAIN DRAIN
Units I Fees Units Fees
Water Heater 9,001 Size
Water Closet Materia
Bath Tuti .2 To Cur
Shower ,0 To Pron.Line
Lavatories To Existin
Kitchen 'n Not Conn.
Dish Washer
Waste Disposal
Wash Tray STORM DRAINAGE
Washing Machina ,M Size
Water Softener I Material
Bar Sink To Main Drain
Comb.Sink&Tray To Curb
Dental Unit
Drinking Fountain
Floor Drain WATER SYSTEM
Hopper Size ii
Restaurant Sink Material
Sand Trap T07,kL FEES
Urinal Fixture Fee
Area Drain Main Drain Fee Q
Water Leader Storm Drain Fee
Sprinkler System Water Sys.Fee ,00
Relief Valve I Ciq Fee rD
Vac Breaker
Skimmer
Filter
Pool Sweeper
Permit Fee U r7
Total Total Fee l�.O