511820
eg _ Lot No.
,i ..
APPLICATION FOR PLUMBING PERMIT
CITY OF CUPERTINO
Sanitary No)
-� S/i 01 L
Date , 196_ r+ PermitiNo.
Fee S U d
Application is hereby made to the City of Cupertino for a permit to install plumbing pipes
and/or fixtures listed on the reverse side hereof, and agrees _to install said prices and/or fixtures
in accordance with the provisions of the Plumbing Code of the Cityof Cupertino, and all other
laws applicable thereto.
Use of Pre�misises
Owner
BY �.9.•i�v///r>
' Contractfir, Agent
Phone '�'
State License
1 '6.1
Address
Address/,- tJX !�--IT ,�y�S l9io-t
,/--LS .
Approved
Plumbing Inspector
FIXTURES
NUMBER
MAIN DRAIN
Units Fees
Units Fees
Water Heater
Size
Water Closet
Material
Bath Tub
Shower
Prop.
Lavatories
Kitchen Sink
Dish Washer
rNotConn.
Waste Dis osal
Wash Tra
AINAGE
Washin Machine
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 Leader
Storm Drain Fee
Sprinkler System
Water Sys. Fee
Relief Valve
Ga� Fee
Vac Breaker
Skimmer
Filter
Permit Fee
Total
Total Fee
2/438 I MA t� V\ LOT NO. 9z
NO. STREET v/ _ A(o5
APPLICATION FOR PLUMBING PERMIT
CITY OF CUPERTINO 577'10
Q Sanitary Nn.
,� a ,196 Permit No J511p9�AUL? }pr,�,�L'A�
Fee q�0Applications NRb}' the City of Cupertino for a permit to install plumbing
iges and/or fixtureslist+!f, the reverse side hereof, and agrees to install said prices
3rdj/�QJi'xtyrg in accordance with the provisions of the Plumbing Code of the City of
Cupertino, 3n� rjglJ er„ laws applicable thereto.
Use of Premises
Owner-+ m—r on 1. EJ A t-
,
z DyV6,1- Qpm an
O CO NTRACTOR, AGtiNT
3 r
—ua, Phone -2.96' i941�
w Z
¢f State License 175z99
Total
FIXTURES
NUMBER
MAIN DRAIN
UNITS F FEES
UNITS FEES
Water Ileater
0
Size
Water Closet
Material
Bath Tub
I O
To Curb
Shower
/
To Prop. Line
Lavatories
To Existing
Kitchen Sink
Not Conn.
Dish Washer
Sewer Box
Waste Disposal
Wash Tray
STORM DRAINAGE
Washing Machine
/ , SV
Size -
Water Softener
Material
Bar Sink
To Main Drain
Comb.Sink & Tray
To Curb
Dental Unit
Drinking Fountain
Floor Drain
WATER SYSTEM
Hopper
Size 11Restaurant
Sink
Material
Sand Trap
TOTAL FMS
Urinal
Fixture Fee
Area Drain
Bain Drain Fee 0O
Water Leader
Storm Drain Fee
Sprinkler Valve
Water Sys. Fee . '0
Relief Valve
Gas Fee
Vac Breaker
Skimmer
Filter
Permit Fee , .6 O
Total