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51192/993 8 17�&k j'6 1Y / ` T LUT NO. STREET APPLICATION FOR PLUMBING PERMIT V)Iie CITY OF CUPF:RTINO zYSanitar NuU 1 t0�o 3/� 196T Permit No. 3U i LL Fee S '2 3 <� r 0 Application is hereby made to the City of Cupertino for a permit to install plumbing `o 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. wx r r ,. Use of Premises 00 > r 3 Owner Address o a z z By SOMAR 1,9JO•1 Qiee Address 0 30 `b Ca3"629�—o'sem w 0 Phone—;aR-;ese, aWlifernia g 495112 ww sJJ:Li:. �:i D. c.. �,d,_'✓:: 1-; a2 State License �7�63�— Approved - U j� PLUMBING INSPECTOR IAiQFIXTURES NUMBER II MARY DRAIN UNITS I FEES 11 UNITS FEES Closet Shower 1,150 11 To Prop. Line Lavatories 3, DO To Existing Kitchen Sink /.50 Not Conn. Dish Washer Sewer Box Waste Disposal Wash Tray STORM DRAINAGE Washing Machine 50 Size Water Softener Material Bar Sink To Main Drain Comb.Sink & Tray To Curb Dental Unit Drinking Fountain Floor Drain WATER SYSTEM Hopper Size It YO Restaurant Sink Material JGaA, Sand Trap TOTAL FEES Urinal Fixture Fee 13 5,0 Area Drain Main Drain Fee Too Water Leader Storm Drain Fee Sprinkler Valve Water Sys. Fee 9,6 Relief Valve Gas Fee p Vac Breaker Skimmer Filter Permit Fee r7 Total I?..SDI Total Fee 7? cn