51181I(_/ci LOT
NO. STREET
MION FOR PLUMBING PERMIT
dj IL C OF CUPERTINO
ZZ
w
E
o < Date 1968
4-:i2U LE6�
3U
w..
Sanitary Na. 'S'3 93
Permit No
Pee $
Ap@!CTY0nfi Fer(��r�Aftipity of Cupertino for a permit to install plumbing
pipes an /or xtures isle n 4 verse 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 PPreemiseessc.. X 0 .
Owners - Addresses -r/ '•
fir. a� ¢. z 0.
By - G•�: Address /ate 01'7 h l�i�t� �t
CONTMC , AGENT �� (..• -4� /
Phone �7s' �a a p
State License a3 Approved
PLUMBING INSPECTOR
� Yermi[ Nee
Total %3.S Total Fee �� ��
FIXTURES
NUMBER
MAIN DRAIN
UNITS
FEES
UNITS FEES
Water Beater
/
. S -o
Size o0
Water Closet
Material 47-1
Bath Tub
/
5'V
To Curb
Shower
/
,So
To Prop. Line
Lavatories
_oo
To Existing
Kitchen Sink
,S o
Not Conn.
Dish Washer
- ° -
Sewer Box
Waste Disposal
/
�-
Wash Tray
STORM DRAINAGE
Washing Machine
/-
iso
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 6121,1.1
Sand Trap
TOTAL FEES
Urinal
Fixture Fee /3 s-0
Area Drain
I
Main Drain Fee
Water Leader -
Stom Drain Fee
rinkler Valve
Water Sys. Fee / 5-0
Relief Valve
Gas Fee / SC
� Yermi[ Nee
Total %3.S Total Fee �� ��