2585 AILOT NO. _
VNOC q
FEB lA'Pp;�.`-i to ,f1 FOR. PLUMBING PERMIT
CITY OF CUPERTINO
lz� Permit No. ams
y mo
Fee $ �0
Application is hereby made to the City of Cupertino for a permit to install plumbing
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
Cupertino, and all other laws applicable thereto. '/
Pr' Use of Premises S�' `-� Uy E ��,SC�P�� Cfft/RCff
'a
W) Owner — " ` � /� Address
Ylkl,4A /V SON Address !!IET 5
CONTRACTOR, AGENT
Phone 45-4 ; T .�..3� T
Approv
PLUMBING INSPE�
I �
TURES NUMBER MAIN DRAIN
UNITS I FEES IUNITS FEES
Water Heater I/ Size I_
Water Closets ,3 I,3 II Materi'kl �T�U
Bath Tubs To Curb xI
Showers To Prop. Line
Lavatories To E
Kitchen Sinks N Conn
Dish Washers
Waste
{—f--
Waste Disposals f—I--
Wash Trays II STORM DRAINAGE
Washing Machines Size
Water Softeners Material
Bar Sinks II To Main Drain I I
Cortlb. Sink h Traysl To Curb
Dental,Units ill'o
Drinking Fountains) II
Floor Drains L WATER SYSTEM
H
oppers � ' � S¢e ��� v�—
Restaurant Sinks Material
Sand Traps TOTAL FE�%
Urinals f. / Fixture Fee.
Area Drains II Main Drain FeeXI a-G O
Water Leaders 11 Storm Drain Fee I .e
Sprinkler Varves 11 Water Sys. Fee XI
11 Permit Fee Ia,o d
TOTAL -II TOTAL FEE ,7-o _o
REC RD OF INSPECT
Partial Rough
Rough Complete
Final