51182LOT NO. -91 ILrLCG Y.XJi
NO. Sn EF.I'
APPLICATION FOR PLUMBING PERMIT
z d C [T'.5.0,L,CUPERTINO
r/ nitary No.
0
0 Date P&mit No
9 1968 pli Fee $ 9. -5-0
O Application is herej5y/mq�e to the City of Cupec`no-for a permit to install plumbing
`o pipes and/or fixturesIlisted or(IR ray'crse side hereof,'and agrees to install said prices
i m bl
and/or fixtures in accordance with thY11DcysiO s of the Plumbing Code of the City of
< w Cupertino, and all other laws applicae th r44410
w x -
a Use of
001/7 _
3 Owner lJ L Address
By-lop Amaral Plumbing, Ine Add resSto0-1 --V Asn
0 CONTRACTOR, A ENT
3
Phone -214 396-3 �~ �✓ li�N/LK/
w z
� Approved
WILLIAM D. BENEVICH
a o State License.
- U / PLUMBING INSPECTOR
V/ x
FIXTURES I NUMBER
UNITS FE
Shower
IFS
n�
MAIN DRAIN
UNITS
Size �r
Material
To Curb
'Co Pro .Line t/
To Existing.,
Not Conn. -
Sewer Box
Washln achine Size
Bar Sink
To Main Drain
Comb.Sink & Troy
To Curb
Dental Unit
Drinking Fountain
Floor Drain
WA'T'ER SYSTEM
Hopper
Size I
/",
Restaurant Sink
Material
Sand Trap
TOTAL FEES
Urinal
Fixture Fee
Area Drain
Main Drain Fee
Water Leader
Storm Drain Fee
Sprinkler Valve
Water Sys. Fee
, Sd
Relief Valve
Cas Fee
,SO
Vac Breaker
Skimmer
Filter
Permit Fee
, p2
Total
/ „rp Total Fee
SD