51189 - Lot No. 590
0
c
T'E
h
O
ro
o c;
`c
o
=t
3 i
No. Street
Crry OF CUPEERTINO
DEC 2 2 1971
Pi( r
Lot No.
APPLICATION FOR PLUMBING PERMIT
CITY OF CUPERTINO
PDA Y -,D %.f 19%,
Sanitary No.
Permit No.
Fee $ 0
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 Premise"s 7 • (-112
Owner /..-[�`('�Cy L-dx.I
BY
Contra/c//to gent
Phone �%� - ( 7w
State License
Address/7/79e-Lfd�t /T
LANOIE PLUMBING CO., IIJC
Address
zyOV Winchester Boulevard
Campbell, Colilornia 95008
Approved r�
xJ1r Plumbing Inspector e/
FIXTURES
NUMBER
MAIN DRAIN
Units Fees
I I Units Fees
Water Heater
I Size
Water Closet
Material
Bath Tub
ID y
To Curb
Shower
A •
To Prep. Line
Lavatories
16 01
To Exi t'
Kitchen Sin
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
Material G.
Sand Trap
TOTAL FEES
Urinal
Fixture Fee
-c
Area Drain
Main Drain Fee
Water Leader
St m Drain Fee
Sprinkler System
Water Sys. Fee
-e
Relief Valve
11
Gas Fee
O
Vac Breaker
'o.
Skimmer
Filter
Permit Fee
- eA
Total
lye,
Total Fee
—0