2759 (2) /O . 5 EF.TEET GR �. 'LOT NO.
NO. _ Y,S--�
�LI¢T1 FOR PLUMBING PERMIT
a D fj'C�rj
OF CUPERTINO � 7"
o JUN 23 9964 sanitary No.
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Date 196— Permit No Q 765-9
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C) mo.
' o APIT'Yi0%lt G�� �¢�City of Cupertino for a permit to install plumbing
o a pipes and/or ixtures ate on the reverse side hereof, and agrees to install said prices
i < and/or fixtures in accordance with the provisions of the Plumbing Code of the City of
a w Cupertino, and all other la s applic le thereto. -
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w Use Of Pre 'ses
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z J Own Address o� ` J
z By & Address - C I-,; C':r���i✓.c ,o t/r-/�,�
3 CONTRACTOR, AGE NT
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— Phone 37R - 9s �sS _L �
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a State Licensea� 971W Approved
- U PLUMBING INSPECTOR
i
UNITS FEES UNITS FEES
Water Heate I Size IV
Water Closets Material
Bath Tubs To Curb
Showers To Prop. Line
Lavatories 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
Floor Drains WATER SYSTEM
Hoppers Size r
Restaurant Sinks Material q
San Traps TOTAL•FEES
Urinals Fixture Fee' % :/
Area Drains Main Drain Fee O
Water Leaders Storm Drain Fee
Sprinkler Valves Water Sys. Fee 00
Permit Fee
TOTAL no
I RECORD OF IN PE 10
Underground Rough..
Partial Rough..
Rough. Complete.. �,�— /
Main Drain y�
rima... '