1426 0 0
/a 0 LOT NO.
NO. STREET -
P4UMBING PERMIT
C 16% ERTINO
'/^ /
Date 195_ Permit No. 1*1�4
a CITY OE CiJPERTINO Pee
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
n'1 and/or fixtures in accordance with the provisionsofthe Plumbing Code of the City of
Cupertino, and all other laws applicable thereto.
Use of Premises-4-41-1 �
:a
v
0w1erL4#& %, Address C.0 60.�l X61 0
a
By /OAddress
CONTR�AfLOR, AGENT
�t-�-Phone Approv
PLUMBING INSPECTOR
URCS�NUNIBE M I JDR�irT
- UEES UNITSFEESz
ater —size
cater lMteriaWat r Hose � II !�// •
e S:
BatIyTubs / To Curb
hovers I I To Prop. Line
Lavatorie', I II To Existing
Ki ..Sinks on
/ I Not on
Distil W ashgrs /
WAsstte Disposals
s
,wash .Trays I I S'CORM DRAINAGE
slam hing.Machmes I I I Size
;Water SOftcncrs I I Material I j
B nks To Main' iDra'i❑
IC (ink x Traysl To Curb I_ ;
�DPen al Units I I�
,Dunking Fountains)
;Floer Drains I WATER SYSTEM
Hoppers I L Size 3 M1- .
Restaurant,SinksIatenal� � I '_
!-- TOTA`L FEES
an Traps
Urinals I I Fixture Fee -
VeXrea Driins I I II Main Drain Fee
s'Water Leaders I I Storm Drain Tee
Sgnnklcr Vaives —�—F Watet Sys. F„ee
• / .SOI Fermin Fee
PTOTAL I /S OTA.L FEE, o,
v P' ION
Partial A.ough
VRough C:o et 7–
�Final _ IA �
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