NO PERMIT NUMBER "M I WH0,g tON aQ LOT NO. GI
NO. STREET
APPLICATION FOR PLUMBING PERMIT
CITY OF CUPERTINO
z
r o Sanitary No.
LL
o < Date 196-T Permit No
W LL Fee $ �9 S^ '
xo
� Application is hereby made to ty rti r a permit to install plumbing
o pipes and/or fixtures listed on t f, nd es to install said prices
> a and/or fixtures in accordance wi e provisions o Plg Code of the (:rty of
a w Cupertino, and all other laws a i�of�feGetq. 1968
LL Use of Premises Premiises
fL. OF 1/JJ0n
Owner
_ lre1p97p
y �
z By &nbat SPA iCQk&,ssQAt.
3 0 CONTRACTOR, AGENT 625 Charles Street
- < Phone f O
� SSbSaH�� 6alifornia 95112
w
0a M � Approved
a o State License
Ms
„C PLUMBING INSPECTOR
FIX'T'URES NUMBER MAIN DRAIN
UNITS FEES UNITS FEES
Water Heater —D Size " ,Q7
Water Closet $.DO Material �.
Bath Tub o To Curb
Shower 1SV To Prop. Line
Lavatories 3 .SD To Existing
Kitchen Sink LSO Not Conn.
Dish Washer Sewer Box
Waste Disposal
Wash Tray STORM DRAINAGE
-
Washing Machine e.� Size
Water Softener Material
Bar Sink To n Drain
Comb.Sink&Tray 7o Curb
Dental Unit
Drinking Fountain
Floor Drain WATER SYSTEM
Hopper Size
Restaurant Sink Material I/
Sand Trap 'TOTAL FEES
Urinal Fixture Fee
Area Drain Main Drain Fee f3 n
Water Leader Storm Thain Fee �-
Sprinkler Valve Water Sys.Fee
Relief Valve Gas Fee
Vac Breaker
Skimmer
Filler
Permit Fee Ov
Total pp Total Fee 0-t_S (70