51039 O pL / / I /� ,L1 N:/V LOT NO.
NO. STEEP.T
APPLICATION FOR PLUMBING PERMIT
a CITY OF CUPERTINO
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Y 0 'Sanitary No.
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0 a Date 196 Permit No lS _
Wu Fee $ -z7z `�
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LL W Application is hereby made to the City of Cupertino for a permit to install Plumbing
0 pipes and/or fixtures listed on the reverse side hereof, and agrees to install said rices
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> and/or fixtures in accordance with the provisions of the Plumbing Code of the City of
a w Cupertino, and all other laws applicable thereto.
LL Use of Premises
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3 Owner( //F 7077E�/ Address /02VI AVhW/"AP l✓-
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J z By F,4y4l r SOFT GUwTE,e �/UG, Address
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u i State License 36 Approved
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U PLUMBING INSPECTOR
FIXTURES 1 BER MAIN
UNITS FEES UNITS FEES
Water Heate Size
Water Closets Material
Bath Tubs To Curb
Showers To Prop. Line
Lavatories To Existing
Kitchen Sinks Not Conn.
Dish Washers 11 Sewer Boxes
Waste Disposals
as1 Trays STORM DRAINAGE
Washing Machines Size
Water Softeners Material
Bar Sinks To Main Drain
:Com . Sink s Trays To Curb
Dental Units
Drinking Fountains
Floor Drains WATER.SYSTEM
Hoppers Size
Restaurant Sinks Material
San raps TOTAL FEES
Urinals Fixture Fee 2 ._
Area Drains Main Drain Fee
mater Leaders Storm Drain Fee
sprinkler Valves Water Sys. Fee
Permit Fee 1,�
TOTAL TOTAL FEE
RECORD OF INSPECTION
Underground Rough...
Partial Rough..
Rough. Complete.,
Main Drain
Final...