51145 (2) ,9- 1701 6f% LOT NO.
NO. ST EErl
APPLICATION FOR PLUMBING PERMIT
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TY CUPERTINO
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Sanitary No.
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3 , DateiM1 J 6� Permit No JW-1/j,
w Fee S
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o Application is her toity of Cupertino for a permit to install plumbing
o a pip i � r ��rc` � �thQersc side hereof, and agrees to install said prices
> r and b x ures m 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
00
3 Owner ga' Address
z� CROWN PLUMBING CO. II CROWN LUMBINC CO. INC.
o By P. (O:O.t�Bo�,zp��R�0R9� �G Address ng. Se* @ng.
3 < SaratUy(]T AIOinfi"T Sorornaa. Col;'
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o State License Approved
- kPLUMBING INSPECTOR
FIXTURES NW1 13ER MAIN DRAIN
UNITS FEES UNITSI FEES
Water Heate Size
Water Closets Material
bath Tubs To Curb
Showers To Prop. Line
Lavatories 3 To Existing
Kitchen Sinks Not Conn.
Dish Washers Sewer Boxes
Waste Disposals
\Y/as'h Trays STORM DRAINAGE
Washing Machines Size
Water Softeners Material
Bar Sinks To Main Drain
Com . Sink v Trays To Curb
Dental Units
Drinking Fountains
Floor Drains WATER SYSTEM
Hoppers Size 1,7_
Restaurant Sinks MaterialGgL
San Traps TOTAL FEES
Urinals Fixture Fee
Area Drains Main Drain
��/ater Leaders Storm Drain Fee
Sprinkler valves Water Sys. Fee p-t)
Permit Fee 0
TOTAL 0 TOTAL FEE 0
RECORD OF INSPECTION
Underground Rough
Partial Rough
Rough. Complete
Hain Drain
Final