51140 .Zasr70 SUN/Z/SE PRI ✓'e LOT NO.
NO.
R PLUMBING PERMIT
z < Cl OF CUPERTINO
x o ,1U 14 1970 Sanitary No.
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3a Date �Y Pq 19$1 Permit No �� -too
U
LL � PF CUPERTIN Fee $
0 Apple n�is PF made 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
> and/or fixtures in accordance with the provisions of the Plumbing Code of the City of
I
w Cupertino, and all of/her laws applicable thereto.
Use of Premises -<A-6- d C.
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3 Owne� /SVS .<9 AddresszCL'�' a S�t1215--F u
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O �J COONTRACTO , AGENT
3 uai Phone ` �J —�.� 6 O
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rc a Z Z. Z O WILLIAM U. BENEVIC34
c o State License Approved
U PLUMBING INSPECTOR
FIXTURES NUMBER MAIN DRAIN
Units Fees 11Uni[s Fees
Water Heater Size
Water Closet Material
Bath Tub To Curb
Shower To ProD. Line
Lavatories To Existin
Kitchen Sink 11 Not nn.
Dish Washer
Waste Disposal
Wash Tray STORM DRAINAGE
Washing Machine Size
Water Softener Material
Bar Sink - To Main Drain
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 Storm Drain Fee
Sprinkler System Water Sys. Fee
Relief Valvef aS�
Vac Breaker
Skimmer
Filter
Pool Sweeper I
Permit Fee
Total 7? Total Fee
Lam.