51099.1 oza77/ I /21,d, , LOT NO.
NO. STRFFT'
PP I§ F PLUMBING PERMIT
z < - h UJPERTINO
w �
0 g� 11, Sanitary ijNo.
fMW327196$
3 a Date 196 Permit No
u pS v
w e �11 ELMS n Fee i 3
° Applicptio�`�s' here�y na p Pt 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
> 1- 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
Use of Premises
J LL _
00 Owner -G '' e Aw Addresso a
Z
J '1/�/ "' y/,�'t,,,, G /�
J z By J�-�/� 1. Address
CONTRA OR, AGENTLa
3 < Phone.
wz
a WILLIAM D. 13ENEIIIH
a o State License �`S�'?a Approved
Pl- LIBING INSPECTOR '/
Ix I URESNUMBER
UNITS FEES UNITS FEES
Water Hea[e �Z 3.00 Size rr
�•.Ob
Water Closets (.0 0 Material C,
Bath Tubs 3.00 To Curb
Showers L 3.00 To Prop. Line
Lavatories .00 To Existing
Kitchen Sinks y ,3,00 Not Conn.
Dish Washers 11 Sewer Boxes
Waste Disposals 400
Wash Trays STORM DRAINAGE
Washing Machines 2, 3,00 Size
Water Softeners Material
Bar Sinks To Main Drain
Com . Sinks Trays To Curb
Dental Units
Drinking Fountains
Floor Drains WATER SYSTEM
Hoppers Size J"
Restaurant Sinks Material ag Iv.
San Tri aps TOTAL FEES
rinals Fixture Fee 7,o
Ata Drains Main Drain Fee �j 00
Water leaders Storm Drain Fee
Sprinkler Valves Water Sys. Fee /.r0
Permit Fee .).00
TOTAL TOTAL FEE 3(! f0
RECORD OF INSPECTION
Underground Rough
Partial Rough
Rough. Complete
Main Drain
Final