HomeMy WebLinkAboutNO PERMIT NUMBER (3) No. Street Lot No.
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d APPLICATION FOR PLUMBING PERMIT
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Date 94 3 , I9 W 3 N" Permit No.
° Fee S Z..V
3
Application is hereby mad %TM grof Sup fo a permit to install plumbing pipes
and/or (fixtures listed on the e'verste s9deihereof;:ad�a�g{yeSlio13stall said prices and/or fixtures
in accordance with the provisions of the Plumbing Code of the City of Cupertino,and all other
'c laws applicable thereto.
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Use of Premises cdPegC e
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° Owne�jQ/� AIV04L &2 Address S/f^IZ79644'ii'W
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By Son ,7' r1AG . Address S�/L' 70se
3 Contractor,Agent
° Phone o293'907 7
a N%ILLIF:L7 D. B=NEVICj
State License - 89 3.1� Approved
x Plumbing Inspector
FIXTURES NUMBER MAIN DRAIN
Units Fees Units Fees
Water Heater Size
Water Closet Materia '—
Bath Tub To Curb
Shower To Prop. Line
Lavatories To Exist'"
Kitchen Sink Not Conn.
Dish Washe
Waste Diso I
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 I MateriaVkJO
Sand Trap T AL FEES
Urinal Fixture Fee
Area Drain Main Drain Fee .VO
Water Leader Storm Drain Fee
Sprinkler System Water Sys.Fee O
Relief Valve Gm Fee
Vac Breaker
Skimmer
Filter
Permit Fee 00
Total Total Fee •.I—O