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2340
_ ` 4') •� LOT NO. Ol ® N S F.F. APPLIC TION. FOR_PLUMBING PERMIT wz AUG 13 1963 ITY OF CUPERTINO x p Sanitary No. a0 J � ? 3 U. ��1� 'r 196— Permit No3 1/0 Fee $ i L+ ' Qz) � o � Application is hereby made to the City of Cupertino for a permit to install plumbing `oa pipes and/or fixtures listed on the reversesidehereof, and agrees to install said prices > and/or fixtures in accordance with the provisions of the Plumbing Code of the City of wCupertino, and all other laws applicable thereto. Use of Premises 00 \\ oi Owner I AddresS�I.I V2t,YJCtS L ZJ J z l JC1 ti� Address �Q© I � zV 11 _ o 3 i- CONTRACTOR, AGENT - m Phone C L I b I-k b y wz _ w W ��7 gt7 E State License - Approved PLUMBING INSPECTOR FIXTURES NUMBER I DRAIN UNITS FEES UNITS FEES Wamr Heater j Size Water Closets 0.1.. Mates; GS Nath Tubs To Curb Showers ( To Prop. Line Lavatories �„ To Existing Kitchen Sinks ( Not Conn. Dish Washers ( Sewer Boxes Waste Disposals Wash Trays STORM DRAINAGE Washing Machines / Size Water Softeners Material Bar.Sinks To Main Drain Comb. Sink r Trays To Curb Dental Units Drinking Fountains Floor Drajns WATER SYSTEM Hoppers Size (' Restaurant Sinks Material G San Traps TOTAL FEES Uiinals Fixture Fee Arca Drains Main Drain Fee Water Leaders Storm Drain Fee 5prinklor 711. Water Sys. Fee Permit Fee TOTAL TOTAL FEE RECORD OF INSPECTION Underground Rough_.,P—.-2;7--3 .Partial —.-2;7— .Partial Rough.. 117—.? .Rough. Complete.. —,S \4ain Drain Final...