51122 LOT NO.
PP TION FOR PLUMBING PERMIT
w < � V3 CITY OF CUPERTINO
3 � (� sanitary No.
tF�C 2 (` � 1960 Permit No ��/=
U �+ Fee $ Io
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o lic%An is hereby made to the City of Cupertino for a permit to install plumbing
o a 9011.1/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
a w Cupertino, and all other laws applicably thereto.
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Use of Premises
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. 3 Owner�C.t� Lr V,4ea7eaP.- Address Wr v errs
°-I ALWIN PLUMBING CO. d
By 4
3 0 " 'CONTR`Ac'rOflrAGBNT AD
— PhnREDWOOD CITY. CALIF 365_0714
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< 0 state License. �/ S5 �� Approved
U PLUMBING INSPECTOR
FIXTURES NUMBER MAIN DRAIN
Units Fees Units Fees
Water Heater Size
Water Closet Material
Bath Tub To Curb
Shower To Prop. Line
Lavatories xi
Kitchm Sink Not Conn.
Dish Washerc
Waste Disposal All
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 D in Fee
Water Leader Stom Drain Fee
Sprinkler System Water Sys. Fee
Relief Valve G2�Fee
Vac Breaker
Skimmer
Filter
Pool Sweeper
Permit Fee , CIOTotal Total Fee