1144 409SS'; PFP/0411 71fZ, LOT NO.
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ST r
r: D PP T FOR PLUMBING PERMIT`"`
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; ION 16 +a
DOF CUPERTINO
��0� 195_ Permit No._ tel- Y
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Fee$
Application is hereby made to the City of Cupertino for a permit to i stall plumbing
ri
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.
8 Use of Premises A S -l"Iye--
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Owner e"dMMn vrvuetrN B"A.< Address o
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By I PUkO y AlkkA/.yG Address ' L
-n- -?�; CONTRACTOR, AGENT - -
bond', — Approved I�
PLUMBING INSPECTOR
FIXTURES NUMBER MAIN DRAIN
UNITS FEES J UNITS FEES
Water Heater II Size .r`i- Aw I
Water Closets ` 3 :, 11 Material- _1c / I
Bath Tubs- II To Curb I I
Showers 2 _',;,"^ I'tTo Prop. Line • V
Lavatories � � - _ >" 1I,,_ 'Existing
Kitchen Sinks' ; ./ • , L `";, ��; No onn i
Dish Washersi-
Waste Disposals =
Wash Trays ^y"•'., 11,x`_ ISTORM DRAINAGE
;Washing Machines / �; a;:..j lySiie,.� j ?•- {
Water Softeners t{=N •.�lMaterial 1
Bar Sinkst11-j6jMain Drain I
Comb. Sink-&'Trays �^TojCdrb' •` �_,
s
Dental Units%,-; ';) - •� `'; wl ��)I'f'}�� ���
5Lr tkkngFouritains .
Floor Drains •"�• r j 11•W.ATER1,SYSTEM
Hoppers
RestaurantSinks_,mr '�r',;# jj„"Dlatertala], je ;,<i
Sand Traps <AJ. •I'1•J :', TOTAL FEES "
Urinals � -• '•�,- j . ��= Fizfur _� /k.'•2S
Area Drains ';.'; .1; -'-?l ��KMain-rDraih-Fee 1 /, 00
Water Leaders, If I,._1 P„Storin-_Drain Fee
Sprinkler Valves iS WaterjL y.- Fee /•D J
4srjYlMrrm . / 4.;r2, }I ,'.PermitjFee'j /.00
TOTAL `'t^ . l /,;'.7fI••TOTALFEES
REC_ RD CTTON r
Partial Rough
Roug*c&nplete :�, •.:}
Fina
,F Liip'ertino Sanitary
Office Copy,
BUILDING INSPECTOR'S OFFICE
CITY OP CUPERTINO
- 0 Sewer'Connection: " � � .. ... Sanitary Pemiit,No. +-..,/:....- . _
F9"� Plumbing [final - .,Plumbing Permit Nc ---------------------
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Date final ......- =4 . ...--
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