942 /,!90-7/ / ✓ ,{' G�I L ' _/�// LOT NO
NO. STREET
T
LTCATION FOR PLUMBING PERMIT
CITY OF CUPERTINO
OCT 2 0 9960 s 95L.Z
Date , 195_ Permit No.
ITY OF CUPERTINO Fee$ 12
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 the o.
o i
L Use of Premi
Owner ��G'n � Address
By Address
CONTRACTOR, AG GT tL� ,
E Phone 3 03 Approv
1o.y� PL BING INSPECTOR
—� TIJRES NUMBER MAIN DRAIN
UNITS FEES IUNITSFEES
Water Heater Il Size
Water Closets Material
Bath Tubs 11 To Curb
Showers To Prop. Line 1
Lavatories 1 II To Existing 1 1
Kitchen Sinks Not Conn.
Ra—
Dish Washers
Waste Disposals 11 1
Wash Trays STORM DRAINAGE
Wa+' ,RttfiriCs' Size
—WaLLr Softenors Material
Bar S'Iks" To Main Drain
Comb, Sink a Trays To Curb
Dental Units
Drinking Fountains) _ 11
Floor Drains WATER SYSTEM
Hoppers Size
Restaurant Sinks Material
Sand Traps TOTAL FEES
Urinals Fixture Fee /. 0
Area Drains Main Drain Fee '
Water Leaders �� Storm Drain Fee
Sprinkler Vmves / ,0011 Water Sys. Fee
1 1 11 Permit Fee /,0 0
TOTAL 1 TOTAL FEE 0 .np
RECORD OF INSPECTION
Partial Rough
Rough Comp ete
Final