51183 PLUMBING/ / I % I /--\ LOT
NO. STRF.F.I'
,a@wfi440R PLUMBING PERMIT
CI F CUPERTINO
/AUG 28 1968 Sanitary No. S ��
Date 1960. Permit No
�ITY OF CUffRTjNQ. Pee$ad
App ication is hereby ma a to t to rty 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
Cupertino, and all other laws applicable thereto.
Use of Premisesl��Srra4�'y�
Owner -/C C 4 rr �•f�//// - Address
ByG'( W{� Address / Q Q '�90k/�T
CONTRACTOR, AGENT 1147 M( Q Jt-
Phone
CPhone/- a G
State License AR (f/ 7 F5- Approved WILLIAM D. SENEVICH
PLUMBING INSPECTOR 1/
" FIXTURES
NUMBER
MAIN DRAIN
UNITS F FS
I UNITS ES
Water Heater
O
1 Size 4(
Water Closet
Material
Bath Tub
To Curb /
Shower
To Prop. Line
Lavatories
43
To Existing
Kitchen Sink
/ v
Not Conn.
Dish Washer
Sewer Box
Waste Disposalrj
Wash Tray
STORM DRAINAGE
Washing Machine
Size
Water Softener
Material
Bar Sink
To Main {rain
Comb.Sink&'fray
To Curb
Dental Unit
Drinking Fountain
/ /, D
Floor Drain
°ah ,pp 11
WA'T'ER SYSTEM
Hopper
3 And
Size P
Restaurant Sink
Material
Sand Trap
TOTAL FEES
Urinal
Fixture Fee
Area Drain
Main Train Fee
Water Leader
Storm Drain Fee
Sprinkler Valve
'I
Water Sys. Fee 3�
Relief Valve
Gas Fee
Vac Breaker
Skimmer
Filter
�/ 0000 v U
Permit Fee
Total
/'
Total Fee