NO PERMIT NUMBER 22773 1 Voss Ave. 31
OT NO.
NO. $TR F.F,I'
APPLICATION FOR PLUMBING PERMIT
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w �a CITY OF CUPERTINO
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0 < Date 10-4 ifOCT
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3LL i4 F. �la99
� Application is hereby made to the City of Cupertmo1fo�r8 pe Lit-to install plumbing
' i- Pipes and/or fixtures listed on the reverse side hereof, and agrees to install said Prices
r I and/or fixtures in accordance with fhb',i}bviITS efi e) m Code of the City of
to a Cupertino, and all other laws applicab�erthe4cto. r MO
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Use of Premises Residence
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3 Owner Perrotti Construction Add ress2225 Grant Rd. , Los Altos
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Z � W.L. HICKEY SONS INC. 198 Commercial St.
z By ' Address
0 CONTRACTOR,AGENT Sunnyvale
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am Phone 736-4938
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W 95122
a o State License Approved
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4
PLUMBING INSPECTOR V
HX I URESI
UNITS FEES UNITS FEES
Water Heate Z ,j,,o I Size
Water Closets �, Material C,
Bath Tubs To Curb
Showers a 3 ev To Prop. Line
Lavatories. ld " To Existing
Kitchen Sinks A 3,00 Not Conn.
Dish Washers Sewer Boxes
Waste Disposals
Wash Trays STORM DRAINAGE
Washing Machines a Size
Water Softeners Material
Bar Sinks To Main Drain
ComIT Sinks Trays To Curb
Dental Units 4� 3,(/-p
Drinking Fountains
Moor Drains WATER SYSTEM
Hoppers Size j".
Restaurant Sinks Material y
San raps TOTAL FEES
Urinals Fixture Fee
re-Drains Main Drain Fee ..i
Water Leaders Storm Drain Fee
5prinklrr Vatvcs Water Sys. Fe ,3,rrJ
Permit Fee �,P-O
TOTAL TOTAL FEE p, lti
RECORD OF INSPECTION
Underground Rough
Partial Rough
Rough. Complete
Plain Drain
Final