51145-Plumbing Permit a'�✓ /s / '/�/G��/f-/iY�_-�/ LOT NO.
NO. P.ET
[�j 'PP �7�;ON FOR PLUMBING PERMIT
u a ) ITY OF CUPERTINO
w �
f 0 JAN 5 1965 Sanitary No.
Y
LL
0 a' Date 196— Permit No.�
3 o C� Y. �F CUPERTINO Fee $
plica ion is hereby made to the City of 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
and/or fixtures in accordance with the provisions of the Plumbing Code of the City of
aw Cupertino, and all other laws applicable thereto.
W I
w Use of Premises
00
r 3
Owner :4 ddress Q •
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2 o By mit- Address 401-
3 r CONTRACTOR, GENT
– 0 Phone C C
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W
a o
_ State Licensey�3o 7C�7 Approved
PLUMBING INSPECTOR
I I URES NUMBER MAIN DRAIN
UNITS FEES UNITS FEES
Water Heate size
Water Closcts y Material C y'
Bath Tubs / To Curb
Showers To Prop. Line
Lavatories 3 To Existing
Kitchen Sinks Not Conn.
Dish Washers Sewer Boxes
Waste Disposals
Wash Trays STORM DRAINAGE
Washing Machines Size
Water Softeners Material
Bar Sinks To Main Drain
Comb. Sink s Trays To Curb
Dental Units
Drinking Fountains
Moor Drains WATER SYSTEM
Hoppers Size /
Restaurant Sinks Material Co.
Sand Traps TOTAL FEES
Urinals Fixture Fee
Area Drains Main Drain Fee p-J
Water Leaders Storm Drain Fee
�prinAlcr Valvcs Water Sys. Fee 17
Permit Fee
TOTAL � La TOTAL FE/0,00E O
RECORD OF INSPECTION
Underground Rough
Partial Rough
Rough. Complete
Hain Drain
Final