759 f/I /:J�� MI'.I�M�1 l' L•_ /'VIL , LOT NO.
/MVo. o S
'APPLI A FOR PLUMBING" PERMIT
AY 20 1960 OF CUPERTINO ,
195 Permit No.
G
M I Fee $
�1 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 in accordance with the provisions of the Plumbing.Code of the City of
Cupertino, and all other laws applicable thereto. J
Use of Premises .t ♦ L obi +
a
Own �ddress A-
B -t
By1 nn .c..11.e+ 4 nD Address 7j 'Z--��.r( Qn.Q
CON CTOR+/GENT /
Phone.e* V ..0/ 3{u Approv� ✓
/ - PLUMBING INSPECTOR
Fi_XTURES NUMBER _11 MAIN DRAIN
55 I UNITS I FEES I� UNITS FEES
W. 4r Heater Size
Water Closets Material
Bath Tubs To Curb
Showers To Prop. Line
LaJatories To Existing
Kitchen'Sinks �: �� _Not Conn.
Dis�. I j SEWER BOXES
Waste Disposals 11 I_
Wash—Trays - STORM DRAINAGE
Washing Machines idI Size 'I
Water Softeners aterial
'Bar Sink 11 To Main Drain
Comb.Sink & Traysl1 11 To Curb
Dental-Units I 1 l!
Drinking Fountains,- I
Floor Drains WATER SYSTEM
Hoppers Size '- • I I
' Restaurant Sinks - Material ' I I
Sand Traps 11 TOTAL FEES
Urinals - Fixture Fee
Area Drains II Main Drain Fee
Water Leaders - Storm.Drain Fee
Sprinkler Valves' .I - I I _Water Sys. Fee
Permit Fee
TOTAL OTAL FEE
.RECORD OF INSPECTION
Partial Rough
Rough CompI t _
Final