51177.110434 I Dempster
LOT
NO. El'
N FOR PLUMBING PERMIT
AA TY OF CUPERTINO
eE_C 71970s:mitar,, inn.
Date 11-25-70 196— Permit No, __S// 7 2, /
CITY OF CUPERTINO Pee $ 3 n
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
Cupertino, and all other laws applicable thereto.
Use of Premises Residential
Owner Ronald Jones
o • By Il igan Water Condit _
3 r CONTRACTOR, AGENT
— Phone736-2000
w z
wW 241785
rc a
a
State License
Address10434 Dempster
Cupertino, Calif.
Address380 Fast Rvalyn Ave.
Junnyvale, Calif.
Approved
PLUMBING INSPECTOR
Permit Fee
Total Total Fee
FIXTURES NUMBER
MAIN DRAIN
Units Fees
Units Fees
Water Heater
size
Water Closet
Material
Bath Tub
To Curb
Shower
To Prop. Line
Lavatories
To Existing
Kitchen Sink
Not Conn.
Dish Washer
Waste Disposal
Wash Tray
STORM DRAINAGE
Washing Machine 11
Size
Water Softener
Material
Bar Sink
To Main Drain
Comb.Sink & Tray
To Curb
Dental Unit
Drinking Fountain
Floor Drain
WATER SYSTEM
Hopper
Size
Restaurant Sink
Material
Sand Trap
TOTAL FEES
Urinal
Fixture Fee
Area Drain
Main Drain Fee
Water Leader
Storm Drain Fee
Sprinkler System
Water Sys. Fee
Re] ef Valye
Gas Fee
Vac Breaker
Skimmer
Filter
Pool Sweeper
t
Permit Fee
Total Total Fee