NO PERMIT NUMBER (5) /0/75 LOT NO. 7 .7
No.. >ZA ZSTREPI = ♦1
/ APPL'ICATION, FOR PLUMBING PERMIT
N Q .Q 1
z _ CITY OF CUPERTINO
x a ,_. .� au] ,�4 �sss p- Sanitary No.
0 a Date 1962 Permit No
3 u . Fee $ 29So
j LL
0 Application is hereby made to 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 prices
r and/or fixtures in accordance with the provisions of the Plumbing Code of the City of
a w Cupertino, and all other
/laws applicable thereto.
LL Use of Premises K ��
00
,. 3
, Owner Address
0a
zJ
z By �E'zt/T�4iI-G COIL- Address&f
O CONTRACTOR, AGENT,
3 < �
— ua, Phone /O '
w z - 7 WILLIAM D. BENEVICH
ww
ao State License 71J-3 7 Approved
1U- —U PLUMBING INSPECTOR ✓
FIXTURES NUMBER MAIN DRAIN
UNITS1 FEES I UNITS FEES
Water Heater •J'a 11Size 4f
Water Closet .3 W. fD Material
Bath Tub JO To Curb
Shower To Prop. Line
Lavatories LJ- To Existing
Kitchen Sink ,� Not Conn.
Dish Washer Sewer Box
Waste Disposal
Wash Tray STORM DRAINAGE
Washing Machine Size
Water Softener Material
Bar Sink To Main Drain i
Comb.Sink&Tray To Cur
Dental Unit
Drinking Fountain
Floor Drain WATER SYSTEM
Hopper Size "
Restaurant Sink Material ,9 G J7�
Sand Trap TOTAL. FEES
Urinal Fixture Fee .fes
Area Drain Main Drain Fee
Water Leader Storm Drain Fee —
Sprinkler Valve I Water Sys.Fee j p
Relief Valve Gas Fee
Vac Breaker
Skimmer
Filter
Permit Fee d
6-
Total -xv 'Total Fee ,fU