1047 - zLOT NO.
NO. STR
0TI FOR PLUMBING PERMIT
JAN Z 5 9561 OF CUPERTINO
Date ZS' 14—f Permit No.
OF CUPERTINO Fee ?a�
NApplication is hereby made to the City of Cupertino for a permit to install plumbing
U-� 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
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Address
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I� N C C7MA, AGENT
Phon �� d O Appro
/� LUNBING INSPE OR
�Iul=g-- UM MAIN QKAIN,r
I UNITS I FEES 11
Water Heater I /, , IOU 11 Size
Va-te-f—claos—ets L- j-ZcV I Material
Bath Tvtis To Curb
SK�iwers k
TTProp. Line• I
Lavatories To Exilting ,
Kitchen Sinks
Dish Washers I
Waste Disposals
Wash Trays j j 11 STORM QRAINF-ALt
'Washing Machines 6=111 Size j7,
VW—ater.Softeners j 11 Material
Main Bar Sinks To Main Drain
-Comb.-Sink—& Trays To Curb
DentalUnits;
Drinking Fo untains j II ;fes
Floor Drains j WA'[**-T'R SYSTE
Hopper's jj Size _T
Material (31-a
Restaurant Sinks Kns
TOTtAL FEES
Urinals
Fixture Tee.
-xr—et Main rain Fee I[ C9
Water Leaders ff
Storm Drai' Fee I
-01D
Sprinkler Vi(-Vcs Wate Sys,Jcc:
Ta
:lT—rap,
D
Permit Feel A 0.0
TOTAL
jjo� 11 TOTAL ffE 'f
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