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LOT NO.
CIT,140f CUPERrIM STREET
_ FEB 24' 5ffKATION FOR PLUMBING PERMIT
z a CITY OF CUPERTINO
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Y O .Sanitary No.
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3 a Date z o 19 1 Permit No `S// 3/
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' 0 Application is hereby made to the City of Cupertino for a permit to install plumbing
0q pipes and/or fixtures listed on the reverse side hereof, and agrees to install said prices
'z,U7 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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0'LL Use of Premises
24.5
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. 3 Owner / /26nJH r_t= I_ R. Address -SPI/-67
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Z By AC4 ALa4- otVENT a.,.,.,, y� Address .756 ?,"R'111027� r
O CONTRACTOR,AG
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— W Phone 297 — P/07
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,a2„ State License 2 3 7 SG P Approved
y(��,� PLUMBING INSPECTOR
FIXTURES NUMBER' MAIN DRAIN
Units Fees Units Fees
Water Heater / /,So Size
Water Closet Material
Bath Tub To Curb
Shower To Prop. Line
Lavatories To Existing
Kitchen Sink 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
Restaurant Sink Material
Sand Trap TOTAL FEES
Urinal Fixture Fee
Area Drain Main Drain Fee
Water ea e Storm Drain Fee
Sprinkler System Water Sys.Fee
Vac Breaker
Skimmer
Filter
Pool Sweeper
eemtF2 o0
Total Tot
♦ r
CITY OF CUPERTINO
10300 Torre Ave.
CORRECTION NOTICE
--------------- P ------------
DaparfineM
Job Located at
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You are hereby notified that no more work shall be
done until the above violations are corrected. When
corrections have been made call the inspector.
252.4505 Date: ..... —�
City Telephone' Inspector: .... . .. .... ...... .....
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