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NO. STREET
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` \/ APPLICATION FOR PLUMBING PERMIT
CITY OF CUPERTINO
Date
DEC — 6 j 1138 ' 19j-Q07Permit No.
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Fee S
Application is hereby made to the City of Cupertino for a permit to install plumbing
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
yg Cupertino, and all other laws applicable thereto.
Y, Use of Premises
v U/}+1.�-�iD— R 'L f�D ..1y S epi
N PLUMBMG CO Address
NAR-Transport Street —
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Phone: 328�c(°i. /i° OR, AGENT WILLt/-.:.9 .i. ham:+�cJl4rl
Phone Approved
/% PLUMBING INSPECTOR
DTXI-URE UDt E MAIN
UNITS I FEES 11 JUNITSJ FEES
Water Hcater I Size
Water Closets 00I1 Material
Bath Tubs To Curb
Showers To Prop. Line
Lavatories D To Existing
Kitchen Sinks Not Conn.
Dish Washers
Waste Disposals
Wash Trays TORM DRAINAGE
Washing Machines Size
Water Softeners Maten
Bar Sinks I Toain Drain I I
Comb. Sink a Trays) Z'o Curb
Dental Units �1
Drinking Fountains) I 11 s
Floor Drains WATER STEM
Hoppers Size
Restaurant Sinks Material
Sand Traps TOTAL FEES
Urinals Fixture Fee q J
Area Drains Main Draih Fee
Water Leaders
Sprinkler Valets Water Sys. Fee
Permit Fee �y
TOTAL TOTAL PEE
RECORD OF INSPECTION 67.J--0
Partial Rough
Rough Complete
Final