51125 LOT NO.
NO. SnEE9'
, PMCON FOR PLUMBING PERMIT
'IT
Y OF CUPERTINO
w �
, o /� Sanitary No.
j Date 196-0 Permit No
3 `
W
Fee $ 3so
= O1w CllypliQE,QKPIM
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 pri(es
and/or fixtures in accordance with the provisions o[ the Plumbing Code of the City of_
.a a Cupertino, and all other laws applicable thereto.
w =
0 4 Use of Premises
00
3 OwnerIPO-,n Address��2 jP (✓r Sf/� �/�
°j WIN PUJMBING CO.
o By dress,- •_
CONTRACTOR, AGENT 'CL,
3 Phone FDWOOD CI-1-Y, CALIF. 365-
0714 wz
State License_Z/9/- 3 5 Approved
PLUMBING INSPECTOR
FIXTURES NUMBER„ MAIN DRAIN
Units Fees Units I Fees
Water Heater / Size
Water Closet Material
Bath Tub To Curb
Shower To Pro . Line
Lavatories To Exi tin
Kitchen Sink Not Conn.
Dish Washer
Waste Disposal
Wash Tray STORM DRAINAGE
Washing Machine 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 LMaterial
Sand Trap TOTAL FEES
Urinal LFixture Fee
Area DrainMain Drain Fee
Water Leader St rm Drain Fee
Sprinkler System Water Sys.Fee
Vac Breaker
Skimmer
Filter
Pool Sweeper
Permit Fee c
Total Total Fee S