51016.1 LOT NO,
NO. $TR
CRY Of CU►EA11NO
APPLICATION FOR PLUMBING PERMIT
w JUL 2 0 1971 CITY OF CUPERTINO ,\
x0 Sanitary N0.
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3 4 pp ww ^
U R)M I PLY 13 1981- Permit No
w Pee S
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� Application is hereby made to the City of Cupertino For a permit to install plumbing
`o a pipes and/or fixtures listed on the reverse side hereof, and agrees to install said prices
i and/or fixtures m accordance with the provisions of the Plumbing Code of the City of
a w Cupertino, and all other laws applicable thereto.
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Use of Premises
00
3 Owner Olin Shanroek Address 1135-Normandy dr. CIDP.
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Z By Willi=a Plumbing Co. Address 123—Evelyn MV. View
3 r CONTRACTOR, AGENT
— m Phone 968 — 8900
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a State License 182607 Approved L ✓/
— U.
PLUMBING INSPECTOR
FIXTURES NUMBER MAIN DRAIN
Units Fees Units Fees
Water Heater I ,Jv Size
Water Closet ± ,j 0 Material
Bath Tub 3.0,1 To Curb
Shower / ,d✓ To Prop. Line .0 0
Lavatories uu To Existing
Itchen Sink / . .3a Not Conn.
Dish Washer v MON
Waste Disposal 11
Wash Tray . STORM DRAINAGE
Washing Machine /, a 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 Material
Sand Trap TOTAL FEES
Urinal Fixture Fee ;21,O'D_
Area Drain Main Drain Fee ✓
Water Leader Storm Drain Fee
Sprinkler System Water Sys.Fee 9�
Vac Breaker
Skimmer
Filter
Pool Sweeper
Permit Fee
Total Total Fee 0 VO
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