HomeMy WebLinkAboutNO PERMIT NUMBER (4) 1014-0 LnIzRl� wtq
No. Street Lot No.
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LICATION FOR PLUMBING PERMIT
a 7i ick CITY OF CUPERTINO
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/OCT 22 1970 Sanitary No. 70 O
E Date I D- 2 2 , 198 L Permit No.
3 CITY OF CUPERTINO Fee $Z`—=
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
o in accordance with the provisions of the Plumbing Code of the City of Cupertino,and all other
'E laws applicable thereto.
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m Use o(Premises I � MA �1 L-Y
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d Owner 1"\c Lt_oyst_ Address 1014D
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__ rn By � � L Address ��DR J•
3 Contra ttoor,Agent
/V� Phone
�}--a State LicenseL��- Z44 Approved
l Plumbing Inspector
FIXTURES NUMBER MAIN DRAIN
Units Fees Units Fees
Water Heater Size
Water Closet Material
Bath Tub To Curb
Shower To Prop. Line
Lavatories To Existing
Kitchen Not
Dish Washer
Waste Disposal
Wash Tray STORM DRAINAGE
Washing Machine Size
Water Softener Material
Bar Sink To Main Drain
Comb.Sink&Tray To Curb
Dental Unit
Drinking Fountain
Floor Drain WATER SYSTEM
Hopper Size
Restaurant Sink WfixturcFee
Sand TrapFEES
Urinal Area Drain eWate Leader eeSprinkler System
Vac Breaker
Skimmer
Filter
Permit Fee
Total Total Fee (�