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/ B 7Q o aiita(.'�0'h S V/,wS1l QWT NO. NO. `'�E EE. © tAPPLICATION-FOR PLUMBING PERMIT d C[T OF CUPERTINO ro 11 t JU 12 1963 t sanitary No. LL —��— 196 Permit No 3 a Date oa _0G'1Y OF Wfff`"'% dee $ �� O Application is hereby ma e to the City of Cupertino for a permit to install plumbing o a pipes and/or fixtures listed on the reverse side hereof, and agrees to install said prices > r 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. � r Use of Premises lyG C 0 0 3 Owner n I / f /Tl G G • Address oa Z J ` z By / _ Address Z}may Q y 0 ° NTRACTOR,AGENT 0 Phone—C ii,'ef WZ //j u E State License// a / '7Approved a o U� PLUMBING INSPECTOR FIXR .S NUMBER MAINI UNITS FEES UNITS FEES Water Hearer ,w Size rf .Q Water Closes 5-- ,00 Material / Bath Tubs 3Q U To Curb Showers '' ,0 o To Prop. Line Lavatories .u 0 To Existing 'Kitchen Sinks 3.6 U Not Conn. Dish Washers Sewer Boxes Waste Disposals Wash Trays STORM DRAINAGE \Gashing Machines .0U Size Water Softeners Material Bar Sinks To Main Drain Comb. Sink w Trays To Curb Dental Units Drinking Fountains floor Drains WATER SYSTEM Hoppers Size / ' A d Restaurant Sinks Material Sand Traps TOT FEES Urinals Fixture Fee o2/,00 Area Drains Main Drain Fee a,60 Water Leaders Storm Drain Fee Sprinkler Naives Water Sys. Fee 0 Permit Fee .00 TOTAL /,a0 TO AL FEE 00 RECORD'OF NSPE TjION Underground Rough... 2 .Partial Rnugh.. ) \Iain Drain Moll--- l �i