51181 (2)ILIP I5HAYYOH C, 7- LOT
NO. STREET
APPLICATION FOR PLUMBING PERMIT
CITY OF CUPGRTINO
� Sanitary No.
IT
Date?1—'tJUL
,p146_ Permit No 11 1968 L"W") Fee S 00
Application is hereby made to the City of Cupertino for a permit to install plumbing
pipes and o f res U�jerse side hereof, and agrees to install said prices
and/ y�clire1T ac�y ��Ue provisions of the Plumbing Code of the City of
Cupertino, and all other laws applicable thereto.
Use'of Premises 1, A, WN S P a I N K h iTA 5
Ownermfi 101IR S
By 11 !UTA SAS-SPAINte6gR
CONTRAACTOR,AGENT
Phone C -/ — 3 6 elc- O
State License i q 6 s /
Address C;i l -'v o 7 S# A H BION"7
Address'%
PLUMBING INSPECTOR
FIXTURES
NUMBER MAIN DRAIN
UNITS FEES UNITS FEES
Water Heater
Size
Water Closet
Material
Bath Tub
To Curb
Shower
To Prop. Line
Lavatories
To Existing
Kitchen Sink
Dish Washer
r Box
Waste Disposal
Wash Tra
kNotConn.
TORM DRAINAGE
Washin Machine
Water Softener
rial
Bar Sink
ain Thain
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
Area Drain
Main Drain Fee
Water Leader
I Stom:Drain Fee
414
Iter
Permit Fee
Total Fee