100127 222221 McClellan Road LOT NO.
NO. STREET
APPLICATION FOR PLUMBING PERMIT
Z - ! CITY OF CUPERTINO
W o � `�` Sanitary No
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Date - - 1196_ Permit NoGi �� 7
3u �J !AI'K , I�o� ;
W LL Fee StiS�
n0 Application is hereby made to,the City of Cupertino for a permit to install plumbing
0 a pipes''�nd/or)fiztufH',Iistv�'�on�thereverse side hereof, and agrees to install said prices
r and•/or fixtures 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 Caretakers ' residence
00
oa Owner DEEP CLIFF GOLF COURSE AddresP2222 MCClullon RGIad
Jz By ADVANCE PLUMBING CO Address 021 B Trnnari a l A e lle
O CONTRACTOR,AGENT
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— 0 Phone 2.53-l}o50
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WW
ao State License_ 188596 Approved -
-U PLUMBING INSPECTOR
FI. I URES NUMBER MAIN DRAIN
UNITS FEES UNITS FEES
Water Heate 1 Size
Water Closets 3 Material
Bath Tubs To Curb
Showers 1 To Prop. Line
Lavatories 3 To Existing
Kitchen Sinks 1 Not Conn.
Dish Washers Sewer Boxes
Waste Disposals
Wagb Trays STORM DRAINAGE
Washing Machines Size
Water Softeners Material
Bar Sinks To Main Drain
Com . Sink s Trays To Curb
Dental Units
Drinking Fountains
Floor Drains WATER SYSTEM
Hoppers Size
Restaurant Sinks Material Iy
San raps TOTAL FEES
Urinals Fixture Fee
Tr ea Drains Main Drain Fee
W ater Leaders Storm Drain Fee
Sprinkler Valvcs Water Sys. Fee
Permit Fee
TOTAL 10 1 .0 TOTALFEE 23. 0
RECORD OF INSPECTION
Underground Rough...
Partial Rough..
RDugh. Complete..
Main Drain
Final...