HomeMy WebLinkAboutNO PERMIT NUMBER LOT NO.
NO. STRF.F,T
APPLICATION'FQR,�PMING PERMIT
z s �ITY OF CUPERTI 0p
Q g CT 2 1968Satry,No.
o j Date 2 Y 196f Permit No
3 `
x uO I �/ OF CUPFRTI IPee $oZS 6—V
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o Application is hereby made to the City of Cupertino for a permit to install plumbing
o 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
a w Cupertino, and all other s applicable thereto.
,. Use of Pre es
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3 OwnerIAddress zjqq
Z By Address
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CONTRACTOR,3 AGBNj-
m Phone
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Y State License /(� Z / 33 Approved
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U PLUMBING INSPECTOR
FIXTURES NUMBER MAIN DRAIN
llNITS FEES UMTS FEES
Water Heater •577 Size .�u
Water Closet `Y .j•J'd Material Ct' 9
Bath Tub -7-s--75 To-Curb
Shower J •SZ1 To Prop. Line
Lavatories —V To Existin
Kitchen Sink Not Conn.
Dish Washer Sewer Box
Waste Disposal
Wash Tray STORM DRAINAGE
Washing Machine / /,•-p Size
Water Softener Material
Bar Sink / A 4'0 To Main Drain
Comb.Sink&Tray To Curb
Dental Unit
Drinking Fountain
Floor Drain WATER SYSTEM
Hopper Size % f• 0
Restaurant Sink Material
Sand Trap TOTAL FEES
Urinal Fixture Fee - O—o
Area Drain Main Drain Fee .i- &.0
Water Leader Storm Drain Fee
Sprinkler Valve Water Sys.Fee S—co
Relief Valve Gas Fee !•1 0
Vac Breaker
Skimmer
Filter
Permit Fee •0-'D
Total /D /J-0V 11 Total Fee LZ 15 • C