51182-Plumbing Applicationh
Lot No.
APPLICATION FOR PLUMBING PERMIT
CITY OF CUPERTINO
Sanitary No. cn
Date 1196 _� �// ° Permit No.er / IfL
kof o OC
I_ U �J UB �'_ Fee$ 611
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 City of Cupertino, and all other
laws applicable thereto.
Use of
Owner t Address
BY A % /i./ b �J �Yw/��r C./U, Addres3/S �r�� Ica' .
Contractor, Agent G
Phone .�✓`�� ` �-��`-r
.-5� 9 Approved / A6
State License ���/`�^�''-�'"`""'� J'
Plumbing Inspector 1116'
FIXTURES
NUMBER
MAIN DRAIN
Units Fees
Units I Fees
Water Heater
Size
Water Closet
Material
Bath Tub
To Curb
Shower
To Prop. Line
Lavatories
To Existing
Kitchen Sink
N t 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 TrapTOTAL
FEES
Urinal
Fixture Fee
Area Drain
Main Drain Fee
Water Leader
Storm Drain Fee
Sprinkler System
Water Sys. Fee
Relief Valve
11
C..q� Fee
Vac Breaker
Skimmer
Filter
Z7
�
a
Permit Fee
Total
Total Fee
N Q
wz
ai4 9 ,t cyw AO., LOT NO. 9-4
NO. STREET n—t-e" 40-z�
APPLICATION FOR PLUMBING PERMIT
CITY OF CUPC:RTINO S 77"Q
Sanitary No.
196S Permit N1
1 Iib �c c
Fee
GAkpliquon�i1s' hereby made to the City of Cupertino for a permit to install plumbing
pipes arid�or IVJjQIty�_fi� tedn4ntthe reverse side hereof, and agrees to install said prices
and/or fixtures mratc6[darueLwith the provisions of the Plumbing Code of the City of
Cupertino, and all other laws applicable thereto.
Use of Premises
Ow/nner/eLT-n r �-✓ti A .Lr `'
z $0.• 10 l -P A/YM TRACr A A iY�(A
t �
O CONTOR,AGENT
3 < Phone 32(, 3
w z
w w
u State License 175-a99
Add
VG INSPECTOR
FIXTURES
NUMBER
MAIN DRAIN
Material
UNITS FEES
UNITS FEES
Water Heater
O
Size
Water Closet
4-50
Material
Bath Tub
1 4;-0
To Curb
Shower
To Prop. Line v
Lavatories
To Existing
Kitchen §ink/.5-40
Not Conn.
Dish Washer
Sewer Box
Waste Disposal
Wash Tray
S'CORM DRAINAGE
Washing Machine
Q
Size
Water Softener
Material
Bar Sink
To Main Thain
Comb.Sink & Tray
To Curb
Dental Unit
Drinkine Fountain
Hopper
Size
Restaurant Sink
Material
Sand Trap
TOTAL FEES
Urinal
Fixture Fee / , —
Area Thain
Main Thain Fee , 0
Water Leader
Storm Thain Fee
Sprinkler Valve
Water Svs. Fee II.Sn
Total Fee