51234 20040 I Rodrigues LOT NO. 11
NO. Sn EF.I'
CIT! OF CUPEUM CITY OF CUPERTINO 1 / D
" < APPLICATION FOR PLUMBING PERMIT
x o JUN 8 1971 Sanitary .No.
11
0 Da� . ■ r� Ma.Y 24 19 31 Permit No -S/ -3
a
3LL Fee -77 0'
To
� 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
r 1 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 I
Use of Premises Apartments
00
> m
3 Owner Jerome white Address 10159 Sn_ RlaPy
ZJ
, By San Jose Mechanical, Inc- Address 1665 Rogers Ave_ S
o CONTRACTOR, AGENT
3 V:
— am Phone 275-904)
s State License App
264265 rove
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a o
U PLUMBING INSPECTOR t/
FIXTURES NUMBER MAIN DRAIN
Units Fees Units Fees
Water Heater / ,I /.50 Size y
'/ ,T'p
Water Closet 12 /$p0 Material C
Bath Tub 9' '•p0 To Curb
Shower �/ G.00 To Prop. Line
Lavatories /.@ i8.0 To Existing
Kitchen in / .0 Not Conn.
Dish Washer
Waste Disposal
Wash Tray STORM DRAINAGE
Washing Machine 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 eyaVi
Sand Trap TOTAL FEES
Urinal Fixture Fee L ,?U
Area Drain Main Drain Fee Jap
Water Leader
ELS
Fee —
Sprinkler System Water Sys.Fee I.S4
Relief Valve G.q Fee
Jp
Vac Breaker
Skimmer
Filter
Pool Sweeper
[Total'Fee
rFee �,p0
Total JD