51028 03 rGl 7-*AO., LOT NO.
No. T
TION FOR PLUMBING PERMIT
CITY OF CUPERTINO
Y p Sanitary No.
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3 tots,`` O J G 0 19�0 Permit No J,#06`Y^V �4 Fee $
10
pplicatio Is y made to the City of Cupertino for a permit to install plumbing
o a pipes anti/ xtures listed on the reverse side hereof, and agrees to install said prices
z m and stares in accordance with the provisions of the Plumbing Code of the City of
< w Cu o, and all other laws an able thereto.
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0 w Use of Premises
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> 3 Owner C&0 A)09 0 K u p L/; Address /0 3 56 TO "/ /TA W,4V
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J z B}rS 0 OL) k !S T " 04- 5
04- 5 Address 9sg f• E C C A M /nlO R �
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CONTRACTOR, AGENT
3 " 25is= 3610
— m Phone
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a WILLIAM D. SENEVICH
° s• State LicensZO7Z 2 0Z 0 eApproved-
- PLUMBING INSPECTOR V J
FIXTURES NUMBER MAIN DRAIN
Units Fees Units Fees
Water Heater Size
Water Closet Material
Bath Tub To Curb
Shower To Pron. Line
Lavatories xi tin
Kitchen Sink
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 Stom Drain Fee
Sprinkler System Water Sys. Fee
O
Vac Breaker
Skimmer
Filter /
Pool Sweeper
Permit Fee O
Total 78.wll Total Fee