51234 20070 I Rodrigues LOT NO. 13
NO. STREET'
CITY OF CUPEFIMO CITY OF CUPERTINO F•
" a APPLICATION FOR 'PLUMBING PERMIT
xo JUN 8 1971 Sanitary ,N o.
K LL May 24 , 19 11 Permit No ` —1 � 3 x
3 < Da10 A T U
w LL Fee $ S `3
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Application is hereby made to the City of Cupertino for a permit to Install plumbing
a pipes and/or fixtures listed on the reverse side hereof, and agrees to install said prices
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.
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Use of Premises Apartments
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O O
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3 Owner Jer meWhite Address 10159 Sn- RI ahoy
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J , By San Jose Mechanical, Inc Address�K Rngers Avg S _.T-
O CONTRACTOR, AGENT
3 �
Phone
a 264285
u s State License Approved
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U' PLUMBING INSPECTOR r
FIXTURES NUMBER MAIN DRAIN
Units Fees Units Fees
Water Heater / /,sJj Size
Water Closet X ljeMaterial e
Bath Tub G To Curb
Shower 6.6011 To Prop. Line
Lavatories F /a.00 11 To Existing
Kitchen Sin (.0,011 Not Conn
Dish Washer
Waste Disposal
Wash Tray STORM DRAINAGE
Washing Machine Size
Water Softener 11 Material
Bar Sink I To Main Drain
Comb.Sink&Tray To Curb
Dental Unit
Drinking Fountain
Floor Drain WATER SYSTEM
Hopper Size / s "
Restaurant Sink Material Gil✓11
Sand Trap TOTAL FEES
Urinal Fixture Fee ,�D
Area Drain Main Drain Fee S,a f
Water Leader Storm Drain Fee
Sprinkler System Water Sys. Fee
Relief Valve 11 Gas Fee
Vac Breaker
Skimmer
Filter
Pool Sweeper
Permit Fee
Total Total Fee