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51038 20/q2— LA.S CAIPigS W'i./ w.o a►L ret PotgRtor+C—� LOT NO. - NO. STREET APPLICATION FOR PLUMBING PERMIT .z < I OF CUPERTINO wrc Y o f � Sanitary No. Date I Petmit No S� a 3 3u` I,,: is Fees .3.S� Application is hereb m d qty of Cupertino for a permit to install plumbing o a pipes and/gtufix t(�rs 1 si se side hereof, and agrees to install said prices Z N and/or fix s i Icor ante wit t e provisions of the Plumbing Code`oE the City of < w Cupertino, and all other laws applicable thereto. w X J LL Use of Premises _ /��c°y 00 o� Te2 So �j Owner PEG. Address z0/ �/2 4As en,DJS cuqy Zs�f� z Bq ';-L" Address X396_ ®eR2vi—in.v 7 � CO CI'OR,AGHNT ! 3 C7 u< Phone 2 y 7 — b/ wUS w d \ ao State License 2 3 9�a Approved U PLUMBING INSPECTOR FIXTURES NU BER RAM 13RXIN UNITS FEES UNMI FEES Water Heate fSize Water Closets terial ,Bath TubsTip Curb Showers , o Prop. Line Lavatories To Existing Kitchen Si Not Conn. Dish WaslVfS NN Sewer Boxes Waste Dis T-- Wash Trays STORM DRAINAGE Washing Machines Size Water Softeners Material Bar Sinks To Main Drain Co . Sin c a<Trays To Curb Dental Units Drinking Fountains Floor Drains WATER.SYSTEM -ROP persize Restaurant Sinks Material San taps TOTAL FEES U rinals Fixture Fee" ,JO ea rains Main Drain Fee Leaders Storm Drain Fee sprinkler Valves I Water Sys. Fee Permit Fee 57—00 OTAL I TOTAL FEE 3,,S O RECORD OF INSPECTION Underground Rough... Partial Rough.. Rough Complete.. Main Drain Final... CITY OF CUPERTINO 10300 Torre Ave. CORRECTION NOTICE PLUm-eir.rr .............. DaperhneM , job Located at ccyyET�iSa.N. ,.. ----------_-------- . 9 firI RK-1' 0+ !T....................... ................ E. .................. ..........- _---------- - ----------------- ----- ...................... ----------- i ........... --------------- . ..............-------------- -------------------- I . ----------=...............-------- ...----- .......... ----------- i ------------------- ............ ........................... ------------------------- -------------- YLZen hbnotified that no more work shall be bove violations are corrected. When been made call the inspector. Date:nspector: _ .._.._------ .. a