51016.1 45-, a�
LOT NO.
�
NO. STR .l'
N < CITY Of CUPE.TIQPJ PLICATION FOR PLUMBING PERMIT
i ip CITY OF CUPERTINO
x o FEB 1 1971 Sanitary No.
3 �7 Permit
No 3 �U / 6• /
U GG+
w w Pee fy�/
I O
r Application is hereby made to the City of Cupertino for a permit to install plumbing
'o a pipes and/or fixtures listed on the reverse side hereof, and agrees to install said prices
> r 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.
w x
r r
w Use of Premises G's
00
> 0
r 3 Owner7t��1u.v �i-- Address
ZJ
J , By �PS� �B Address ,eof4 e4o� s�f�
J
3 F CONTAAC , AG. T _�Ai��
W Z
w w
a State License !�� -��� Approved �Al (/
PLUMBING INSPECTOR V
FIXTURES NUMBER MAIN DRAIN
Units Fees Units Fees
Water Heater / Size v ,S
Water Closet Material
Bath Tub 1 To Curb
Shower To Prop. Lin
Lavatories 3 To Existing
Kitchen in Not Conn.
Dish Washer
Waste Disposal
Wash Tray STORM DRAINAGE
Washing Machine Size
Water Softener Material
Bar Sink To Main Drain
Comb.Sink&Tray To Curb
Dental Unit
Drinking Fountain
Floor Drain WATER SYSTEM
Hopper Size s-l-
Restaurant Sink Material
Sand Trap TOTAL FEES
Urinal Fixture Fee ZS�
Area Drain Main Drain Fee
Water Leader Storm Drain Fee
Sprinkler System Water Sys.Fee
Sv
Vac Breaker
Skimmer
Filter
Pool Sweeper
Permit Fee S
Total .3 St' Total Fee