51182LOT
NO. STREET'
APPLICATION FOR PLUMBING PERMIT
r Slo1L
CIT:U�f O
Im a u.
Date �6 i 196 i ,i N No
DEC - `3 1968 � Fee $
Application is hereby made to the City of Cupertino for a permit to install plumbing
pipes and/or fixtures listedxgrl',�,elTrs(T.±iilt9{jtee'j(j�}�1 agrees to install said prices .
and/or fixtures in accordance ,th T!1 prhlHt� 'a(� t�{e�'pjumbing Code of the City of
Cupertino, and all other laws applicable thereto.
Use of Premises��J/tn�-r��J ,(
Owner s(.c� Address X V L 1U0Z ,�4[�i.r4tlru,
By. Joe Amaral Plumbing, Inc Address n^O
CONTRACTOR• A ENT 1...�GxiA-o—,'
Phone 4 to — l9:
FIXTURES I NUMBER MAIN DRAIN
UYITSJ FEES 11 UNITS FFE F.S
Water
To
Kitchen $ink/ /„S7f Not Cann.
Dish
her
Sewer Box
Comb.Sink & Tray
To Curb
Dental Unit
Drinkin Fountain
Floor Drain
WATER SYSTEM
Hopper
Size
Restaurant Sink
Material
Sand Trap
TOTAL FEES
Urinal
Fixture Fee
Area Drain
Main Drain Fee
0'7)
Water Leader
Storm Drain Fee
Sprinkler Valve
Water Sys. Fee
)
Relief Valve
Gas Fee
Vac Breaker
Skimmer
Filter
Permit Fee
Total
„sp Total Fee