Plumbing 1013w I ki:E SAL �L LOT NO. .3
NO.- 72
APPLICATION`FOR PLUMBING PERMIT
` I 1 196fCITY OF CUPERTINO
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x o Sanitary No.
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3 < Date -� ��I�';'196 Permit No
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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
rand/or fixtures in accordance with the provisions of the Plumbing Code of the City of
<w Cupertino, and all other laws applicable thereto.
LL Use of Premises �PE S
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r 3 Owner—C-7T, _ ��A�ddreSS
oz J it1t I se'Wi,{'ica �•�. Itl.
J L By 675Cha MrftEet
CONTRACT00., AGENT
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- `m Phone
—� San Jose, California 95112
w z WILLIAM D. BtNEVI\....
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ao State License 7���7 Approved
—U PLUMBING INSPECTOR
1
FIXTURES NUMBER MAIN DRAIN
UNITSJ FEES 11 UNITS FEES
Water Heater / /,S'D Size LlG
Water Closet 3,a) Material t
Bath Tub Z J,. To Curb
Shower To Prop. Line
Lavatories �. 3,042 To Existing
Kitchen Sink / .S' Not Conn.
Dish Washer Sewer Box
Waste Disposal
Wash Tray STORM DRAINAGE
Washing Machine I /. D 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 (/
Sand Trap TOTAL FEES
Urinal Fixture Fee 3 S'n
Area Drain Main Drain Fee OD
Water Leader 11 Storm Drain Fee
Sprinkler Valve Water Sys.Fee SO
Relief Valve Gas Fee SQ
Vac Breaker
Skimmer
Filter
Permit Fee �O
Total /3. Sp 'l'.tat Fee g q -c�'p