1355 LOT NO.
NO.
P YC1OI �OR PLUMBING PERMIT
IM ;F CUPERTINO
t 7
Date IffDEC 12 1961 i5_ Permit No. 13
r CITY OF CUPERTINO Fee $ 14 �: —
�`' Application is hereby made to the City of Cupertino for a permit to install plumbing
N pipes and'/or fixtures listed on the reverse side hereof, and agrees to install said prices
�,9 and/or fixtures in accordance with the provisions of the Plumbing Code of the City of
Cupertino, and all other laws applicable thereto.l/
Use of Premises M M Q QC I � ' I
:a
v _
Owner ddress
By Address
CONTRACTO , AGENT
1 Phone Approved
,L PLUMBING INSPECT
FIXTURES NUMBER MAIN DR IN' ,.
UNITS I F _ �� IUNITS� FEES
Water Heater / I Size
Water Closets 4 � 1I Material
Bath Tubs To Curb
Showers To Prop. Line
Lavatories _ To EXIStIng
Kitchen Sinks
Dish Washers
Washers
Waste Disposals
Wash Trays STORM DRAINAGE
Washing Machines II Size
Water Softeners Material
Bar Sinks To Main Drain
Comb. Sink & Traysl I II To Curb I
Dental Units I 1 11 IMELWW
Drinking Fountains) II _
Floor Drains WATER SYSTEM
oppers Size
Restaurant Sinks Material
Sand TrapsTOTAL FEES
Urinals Fixture Fee _
Area Drains Main Drain Fee
Water Leaders Storm Drain Fee _
S 'nkler Varocs I I I Water Sys. Fee
Permit Fee I I W
TOTAL _ II TOTAL FEE 1
RECqRD,DF I CTION
Partial Rough s
Rough & mplete •\;
Final
+. a