51039 D I �&t-� LOT NO. /
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o A FOR PLUMBING PERMIT
d . Y OF CUPERTINO
ro (AUG 30 1988 Sanitary Nu.
LL
3 j Date Y`;�9 — 196— Permit No �� 9
=LL CITY OF CUPERTINO Pce s13
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
> and/or fixtures in accordance with the provisions of the Plumbing Code of the City of
<w Cupertino, and all other laws applicable thereto.
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� LL Use of Premises 14'es �
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Owner k$114S4r'y Address 09 4P0/'/V4?f.4'0
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J By,¢/If i#"'-C /i. e Address,53A14/,44-PrFir✓o<u 471-".
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— z Phone?/ L
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a 10 State License C'3 G ;? -2 L/$3 Approved . /
-40
PLUMBIN�C INSPECTOR b
FIXTURES NUMBER MAIN DRAIN
UNITS FEES UNITS FEES
Water Heater Size q `I
Water Closet Material C /
Bath Tub To Curb
Shower To Prop. Line
Lavatories -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
Comb.Sink&Tray To Curb
Dental Unit
Drinking Fountain
Floor Drain WATER SYSTEM
Hopper Size f"
Restaurant Sink Material .944y
Sand Trap TOTAL FEES
Urinal Fixture Fee
Area Drain Main Drain Fee .S y
Water Leader Storm Drain Fee
Sprinkler Valve Water Sys.Fee S"U
Relief Valve Gas Fee $U
Vac Breaker
Skimmer
Filter
Permit Fee C`4 FF—
Total Total Fee / , 0-Z