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NO. STR Tq '.
® ®P FLAT t' FOR PLUMBING PERMIT
JUL 2 71962 OF CUPERTINO
Date 7'i� 195 6 ✓ Permit No. I
CITY OF CUPERTINO Fee $�
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.
Use of Premises
� Owner 4A,414N� Address Rk..G! /V
j Byte�' Addres 6 u.a..-
_ CONTRACTOR, AGAT /
Phone3 5/7 % _ Approve(
PLUMBING INSPE T
FIXTURES
NUMBER
MAIN. DRAIN
UNITS FEES
IUNITS FEES
Water Heater
/' /:G>O
Sae 'Al
Water Closetsy
Material
Bath Tubs
/
To Curb
Showers
,
�� To Prop. Line'
Lavatories
To Ex' ing
Kitchen Sinks
,
11 N Conn - n
Dish Washers
/
i�L,_' 4
Waste Disposals
Wash Trays
STORM DRAINAGE
Washing Machines
Size {
Water Softeners
Material
Bar Sinks
To Main Drain
Comb. Sink a Trays
To Curb �_ I
Dental Units
Drinking, Fountains
�
II -�
Floor Drains
WATER SYSTEM
Hoppers
Size /
Restaurant Sinks
Material CG
Sand Traps
TOTAL FEES
Urinals
Fixture Fee I , ,
Area Drains
�� . MainDrain Fee 00
Water Leaders
�� Storm Drain Fee
Sprinkler Vaives
II
Water Sys. Fee I /-00
Permit Fee .00
TOTAL
ja .
TOTAL FEE
• a e e • •
Part'•
Bldg. Dept.
Office Copy-
WILDING
opyBUILDING INSPECTOR'S OFFICE 7"
i CITY OF CUPERTINO'
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Sewer Connection - �.,Sanitary,Permit No......
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Date Fina] �� .. ; _ 9 �L
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PLUMBING INSPECTOR,'.'..
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III 7/61-5oo '