51075 (5) 075 Read at Pruneridge LOT NO.
® JAN 1 �!- 19STIERTI- ,
APPLI TION FOR PLUMBING PERMIT
.Z ' CITY OF CUPERTINO
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� Application is hereby made to the City of Cupertino for a permit to install plumbing
`o a pipes and/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 applicable thereto.
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Use of Premises Leasing Office (Contrs - WTLDER CO-
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3; Owner VALLCO PARK Address Wolfe Rd—Pruneridae
Z J ADVANCE PLUMBING Mz By Address 10218 Tmperl a l p va ,
CONTRACTOR,AGENT UF�+ P,1"t inoD
3 < 253-4o5o
— 0 Phone
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ao State Licensr 188596 Approved
U 4� PLUMBING INSPECTOR (/
I-IX I ORES— NU BER MAIN DRAIN
UNITS FEES UNrrS FEES
Water Heate Jac Size
ater C osets Materia[
Bath Tubs To Curb
Showers To Prop. Line
Lavatories o2 0-2 To Existing
Kitchen Sinks 7 W Not Conn.
ish Washers Sewer Boxes
Waste Disposals
Wash Trays STORM DRAINAGE
Was ing Machines Size
Water Softeners Material
Bar Sinks To Main Drain
Comb. Sink y Trays To Curb
Dental Units
Drin ing Fountains 03
Floor Drains jWAETEERESYESjTEMj*Hoppers ze
Restaurant Sinks Material n /oo
an raps TOTAL FEES
Urinals Fixture Fee /0
rea rams as Main Drain Fee ✓ of
Water Leaders Storm Drain Fee
Sp rinkler ValvesWater Sys. Fee /
Permit Fee
TOTAL o^ TOTAL FEE S oa
RECORD OF INSPECTION
_Underground Rough...
Partial Rough..
Rough. Complete..
Main Drain
Final...