51002.1 2 SAM4 AVENUE LOT NO.PARCEIPRu
NO. STREF.I'
APPLICATION FOR PLUMBING PERMIT
i < Ctry OF�� CITY OF CUPERTINO
w = "'O 7/ 43
MA s:mitary Vin.
OUatc• i �D9$l 17 1 Permit No, E/002. . /
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UF A 1 . Fee s �
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0 Application is'�ifereby 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
> 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.
Use of Premises 00� UN f7' �w�+LINCT
00
3 Owner MII.CHM CONSTRUCTION CO Address 695—VETERANS BLD.
0 a CITY
z By WILLIAMS PLUMBING CO INC. Address 123—EVELYN MTY VIEW-
CONTRACTOR, AGENT
3 �
— Phone 968 — 8900
wz
a 18260'] �
u s Staze'License Approved
a``o7�I--
Q — PLUMBING INSPECTOR
FIXTURES NUMBER 11 MAIN DRAIN
Units I Fees Units Fees
Water Heater / / /,o Size
Water Closet — ,JO Material
Bath Tub G 0 J To Curb C• 5-,00
Shower • / / ,S To Prop. Line
Lavatories 9,00 To Existing
Kitchen Sink 4,00 Not Con.
Dish Washer
Waste Disposal
Wash Tray i 'y o STORM DRAINAGE
Washing Machine/ ,j'6 Size
Water Softener Material
Bar Sink To Main Drain
Comb.S ink&Tray To Curb
Dental Unit
Drinking Fountain
Floor Drain WATER SYSTEM
Hopper Size
Restaurant Sink Material
Sand Trap TOTAL FEES _
Urinal Fixture Fee ' ice
Area Drain Main Drain Fee aG
Water Leader Storm Drain Fee
Sprinkler System Water Sys. Fee /, ;5-IJ
Relief Valve j(3 off 0
Vac Breaker
Skimmer
Filter
Pool Sive per
Permit Fee
Total ou me �, G