2761 v_O1C/ 3 C LOT NO.
ftR
PLUMBING PERMIT
CUPERTINO
rzo /JUI'6Sanitary No.
� LL
3 a Date .,1�6— Permit No
CITY OF CUP
w 'VV Pee
2 LL
0 Application is hereby made to the City of Cupertino fora permit to install plumbing
o` 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 of r laws applicable thereto.
w x
� f
LL Use of Premises
00
> N / n A/
o a
Own�eG ���j Addressl 0/�/ ?i
ZJ
z Byyeea Addres
-j 0CONTRACT OR, AGENT
3 < /
— w Pon — /fes
W-1 a tate Licensel?Y Approved t �y-
a
PLUMBING INSPECTOR
1. RNUMBER MAIN DRAIN
UNITS FEES UNITS FEES
Water Heate Size 41 Ot
Water Closes Materia
Bath Tubs To Curb
Showers To Prop. Line
Lavatories To Existing
Kitchen Sinks Not Conn.
.Dish Was ers Sewer Boxes
_Waste Disllosals
Wasli Trans STORM DRAINAGE
Washing Machines Size
Water Softeners- Material
Bar Sinks To Main Drain
Com . Sink &Trays To Curb
Deptal Units
Drinking Fountains
Floor Drains WATER SYSTEM
Hoppers Size
Restaurant Sinks Material
San Traps TOTAL FEES
rinals Fixture Fee 0-0
rea Drains Main Drain Fee O'O
Water Leaders Storm Drain Fee
Sprinkler Volvcs Water Sys. Fee
Permit Fee , o'G
T
qDiec
un Rough... _
Partial Rough..
Rough. Complete..
Main Drain i n
Final... 4311