51145 PLUMBING O I ' z LOT Nr). _Q:13
NO. "EM'
C FOR PLUMBING PERMIT
z a D OP CUPERTINO
x ° I� MAR J 7 1966 s""i`ar'" N".
p LL ._%/�S
o -' Da 196_ Permit No
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3 a . `Vi��+ ^ids e4t•�•' >1TtlF�'' 7o Pee S �7
o
I c do h t tot Ie 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
r I 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.
w x
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jn Use of Premises
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03 Owne 'Address
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z b Address - 7-
O CONTRAC OR, AGENT
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— m Phone
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ao State License G 3 G" 2 Approved
—U/I PLUMBING INSPECTOR L/
FIX I URESD
UNITS FEES UNITS FEES
Water Hcatn Size
Water Closets ,j Materiald
Bath Tubs To Curb
Showers i To Prop. Line
Lavatories 'j To Existing
Kitchen Sinks Not Conn.
Dish Washers Sewer Boxes
Waste Disposals
N`t/aA 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 G L
San Traps TOTAL FEES
Urinals Fixture Fee
Area Drains Main Drain Fee ps
Water Leaders Storm Drain Fee
��rinklcr Valves Water $yS. Fee . D'Q
Permit Fee
TOTAL 7,7 uu TOTAL FEE Q
RECORD OF INSPECTION
Underground Rough
Partial Rough
Rough. Complete
Hain Drain
Final