51001.3 PLUMBING 'u // /1 iO/1^LCXl LOT NO. <t.�-
NO. STREET
APPLICATION FOR PLUMBING PERMIT
w a � CTY OF CUPERTINO
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x ° �I� �1 Sanitary I�u.
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° a Date +i 4r.-o2 IOC7 i1.96�0 Permit No
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w n Fee$
1 0. Application islhereby, made..to.ihelCity of Cupertino for a permit to install plumbing
o a pipes ;and/or fixtureslli'siedton iheYreverse 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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LL Use of Premises
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3 Owner Address
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J o By v Address
3 F CONTRACTOR, AGENT
— In Phone
f3C,', WILLIAM D. 6EEV
NICI.1
u s State License ���/ /dJ/ Approved
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U PLUMBING INSPECTOR y
FIXTURES NULN BER MAIN DRAIN
UNITS FEES UNITS FEES
Water Heate Size
Water Closets ,j Material
Bath Tubs / To Curb
Showers / To Prop. Line v
Lavatories S 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 s Trays To Curb
Dental Units
Drinking Fountains
Floor Drains WATER SYSTEM
Hoppers Size
Restaurant Sinks Material U/
San Traps TOTAL FEES
Urinals Fixture Feef,00
Area Drains Main Drain Fee S 90
ZV/ater Leaders ate in Fee Sa
Sprinkler V0,. Water Sys. Fee
Permit Fee 00
TOTAL TOTAL FEE pc,
RECORD OF INSPECTION
Underground Rough...
Partial Rough.,
Rough Complete..
\lain Drain
Final._