2693 v/Ooh-!I �h •� LOTNO. "T /
Q STR F.l
P A I�POR PLUMBING PERMIT
d ( TY
OF CUPERTINO
w APR 17 1964 c:'
x o Sanitary No.
a02
3 LL¢o at f
Permit No. 2
Fee $ /S-Gly
� o
Application is hereby made to the City of Cupertino for a permit to install plumbing
o 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
<w Cupertino, and all other laws applicable thereto.
wx
,. Use of PremisesESIOE/UG6
00
> /� S�.
3 Owue,AVc- f Address/ XJ GU!!!/CNES- E76e
J a ByZe 1)'VaYa'�C'/./ ji(e, Address CLf2C-i�
3 �
— 0 Phone
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a o State License / - Approved
.1--IXTURrS NUMBERAI R IN
UNITS FEES UNITS FEES
Water Heater Size eU
Water Closets amp Material
Bath Tubs / / To Curb
Showers / /, To Prop. Line
Lavatories To Existing
Kitchen Sinks O 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 c Trays To Curb
Dental Units
Deinking Fountains
Floor Drains WATER SYSTEM
Hoppers Size
Restaurant Sinks Material
San Traps TOTAL FEES
Urinals Fixture Fee /
Area Drains Main Drain Fee
Crater Leaders Storm Drain Fee
-prinkler Vatvcs Water Sys. Fee Q
Permit Fee a115i9
TOTAL /p Q, TOTAL FEE S,O
RECORD OF INSPECTION
Underground Rough..
.Partial Rough..
.Rough Complete..
\4ain Drain
Final._