1257 Al.?a/ I 1), yye' LOT NO.
NO. STREET •
FOR PLUMBING PERMIT---
® OF CUPERTINO
f SEP 2 6 1961
Date 195_ Permit No..
CITY OF CUPERTINO Fee --��'
Application is hereby made to the City of Cupertino for a permit to install plumbing
Ns pipes and/or fixtures listed on the reverse side hereof, and agrees to install said prices
9
and/or fixtures in accordance with the provisions of the Plumbing Code of the City of
'ki Cupertino, and all other laws applicable thereto.
Use of Premises RFS/n45V0 '
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i
Owner eommnn//JEALTN fU/LOE fS AddressSE
By AZ1,fQ/ Ai u ✓ Address B L
CONTRACTOR, AGENT
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Phone `P- P-�/// Approve .PLUMBING INSPECT
M Im 5
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URL UMB r M R' N
UNITS �. �'FEES;'II 1JUNITS1 ft-EESI
UVorer Hcuier / ''11 Size
_ isten Cosets Material it, k;
--
rB1th TvE j 1 / To Curb L = I 1
Showers To' Prop Lme i'°l+ ✓_ a^
Lavatories 1.__� ) To Existing t. -..1. y
Kitchen Sinks `1 / I N Gmn
ti
Dish Washers
V aste Digpos,a4s 1—/ I—: 1l F 1 71
W:1;4 Trays l l^ - :.1 STORM DRAINAGE
Wauh'ing Machines 1
W�ate So6t`eners 1 1' 1l -Material 1 1
i,Bar Sinks 1 1, I to MainDraig 1 1 `
Comb'. Si��
ink &Traysl -I� To Curb
Dental units
Drinking rountainsl r �—
b 1 loon Drains. l 11 WATT R SYSTEM
Hopper_s l�--1 Size 1 3 �/ �t 4
---- A
Rest3ura' n°t Sl�ks I 1 Material
Sand.l�raps- lfOTfAL rEE5
.Urinals l l - 1 Fixture Nee R O
Area, Drains l 11�Maln—DrabFee„ 1l
I Wafer leaders l 11 Storm Drain.Fee q
sornkl�a1Ve9 l l 1 WaterSyslTee! ;p 0,0
� �pFiw6R eoxEs ! asa 1Permit�Fea+ �, �r �I.'O`G
F TOTAL,, , i TOTAL FEE 7 SO
r 'ECO tD �,ECTION�'
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