511651/
- LOT NO.
NO.
�nyOP CITY OF CUPERTINO
cAftLICATION FOR PLUMBING PERMIT
{�j "� 8 % Z -If
Nu.
Uat4p4) /I/`' 4 19 Permit No S-//as—
/D Pee $�:i
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. 7—
Use of Premises 7-
S i�<��1 /
Owner A�1, �L�.l��.e-�1 - Address�7"/ wows lL�!
f}}' Address�j2i/D ma6l
CONTRACTOR, AG EN Q
Phone ::� l <' —%�3
State License I-� % �� Approved , /
X PLUMBING INSPECTOR
MAIN
Fees
Water Heater
A SC
I Size
Water Closet
n5 741
Material
Bath Tub
To Curb r- ..5. D7
Shower
To Prop. Line
Lavatories
To Existing
Kitchen Sink
Not Conn
Dish Washer
Waste Disposal
Wash Tray
...7 L
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 L /. �)
Fee