2768 �n„ -sevens Creek Boulevard LOT NO.
NO. STREET
N r—�i1PRWICATION FOR PLUMBING PERMIT
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�"�� O .ITY OF CUPFRTINO
x o D 7 Sanitary Nu. W
0 LL b 7
° a / J �1��4 196— Permit No. �
3 LL Fee $ /(4'0 U
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`o � {�li n �s ad�ifo the City of Cupertino for a permit to install plumbing
i� s'an��r fief r s I d°on'khe reverse side hereof, and agrees to install said prices
rand/or fixtures in accordance with the provisions of the Plumbing Code of the City of
a m Cupertino, and all other laws applicable thereto.
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LL Use of Premises Meat Market
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> W690 Kings Row
3 Owner Rhnr3ac CnncY _ Address-
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J Z By Winchester Plumbing Address 1217 Dell Campbell
° CONTRACTOR,AGENT
3 �
- 0 Phone. 378-7615
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oState License 210245 Approved
k` PLUMBING INSPECTOR
FIX I URESNUMBER
UNITS FEES UNITS FEES
Water Heate Size
Water Closets Material
Bath Tubs To Curb
Showers To Prop. Line
Lavatories To Existing
Kitchen Sinks Not Conn.
Dish Washers Sewer Boxes
Waste Disposals
Wash Trays STORM DRAINAGE
Washing Machiries Size
Water Softeners Material
Bar Sinks To Main Drain
Comb. Sink s Trays To Curb
Dental Units
Drinking Fountains
Ploor Drains WATER SYSTEM
Hoppers Size
Restaurant Sinks Material
San Traps TOTAL FEES
Urinals Fixture Fee
re—Drains Main Drain Fee
WX atrr Leaders Storm Drain Fee
Sprinkler Valves Water Sys. Fee
Permit Fee 2 O D
TONAL TOTAL FEE 42400
RECORD OF INSPECTION
Underground Rough...
Partial Rough.. —
Rough. Complete..
Main Drain
Final...