51085 YKO /00
NO. STREET
w jaL A)T ON FOR BUILDING PERMIT
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2 ° - OF CUPERTINO
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S U . 1`�ot1U �/ G O
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`o CITY Fone3 y{t�de for a permit t
i u a� story, F- Building
a w
r ; to be occupied only as in a�ccco�nce with
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0 o plans, Specifications and P Ian filed herewith. P1 Ck Fee
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F ; Estimated Value of Improvements, s2 " Fee$ �S
i J It is hereby agreed that the requirements of the Cupertino Building and Zoning Ordinances and
J = all other laws applicable to the construction, location, and use of buildings within the City of
d O Cupertino will be complied with.
3 C/m� F
_ ,an Owner ,/JL d/�i Address
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By�/I ��0 Addr
< 0CPhone 3S� RD 2 0/ Approved
/ State License-, 1,6 U"mNG INSYF.C1'OR
OT NO.
NO. STREET
r P TION FOR PLUMBING PERMIT
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r o Sanitary No. _
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o ] Da M/yr 196 Permit No
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3 Fee S 00
2 LL
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is�k+Q� �gq,khe City of Cupertino for a permit to install plumbing
LL i s and�Xii�' fix fc7s�1 bhY We 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
<w Cupertino, and all other laws allpliiccabble thereto.
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3 a Sunnyvale, Calif.` 94087 lay L u of g e
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P V LC A
FIXTURES NUMBER MAIN DRAIN
UNITS FEES UNITSI FEES
Water Heazcr Size
Water C Fsets Material
Bath Tubs To Cur
Showers To Prop. Line
Lavatories To Existing ;i ,p p
Kitchen Sinks Not Conn.
Dish Washers Sewer Boxes
Waste Disposals
Wash Trays STORM DRAINAGE
Vias Ing Machines Size
Water Softeners Material
Bar Sinks To Main Drain
Comb. Sink s Trays To Curb
Dental Units
Drinking Fountains
Floor Drains WATER SYSTEM
Hoppers Size
Restaurant Sinks Material
San taps TOTAL FEES
Urina s Fixture Fee
Area rains Main Drain Fee
Water Leaders Storm Drain Fee
Sprinkler Vaivcs Water Sys. Fee
Permit Fee
TOTAL TOTAL FEE Z
, p
RECORD OF INSPECTION
Underground Rough...
.Partial Rough__
Rough. Complete..
Main Drain
Final...