2707 �B/O/ :oHHN Allo/JP/GLS LOT NO. S8
NO. 80515 . R PLUMBING PERMIT
d 9 ��� �� CI I,qF CUPERTINO
o APR 17 1964 �_-� ° sanitary yn_
0 � Date 196`< Permit No
0
3C'.TY OF/ CUPERT"'^ Fee $
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� 0 Application is hereby made to the City of Cupertino for a permit to install plumbing
o a 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
a w Cupertino, and all other laws applicable thereto.
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LLUse of Premises SES/pE/LSE
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r3 Owner - Address
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CONTRACTOR,AGENT
- 0 Phone
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_ 0 State License �9So?99 Approved
PLUMBING INSPECTOR
FIXTURES M L'R MAIN DRAIN
UNITS I FEES UNITS FEES
Water Heater , /9 ) Size
Warer Closets _� �' j Mare ria'_
Bath Tubs ")j To Curb
Showers .) To Prop. Line/
Lavatories /fj i', J� To Existing
Kitchen Sinks j ) Not Conn.
Dish Washers Sewer Boxes
Waste Disposals
Wash Trays STORM DRAINAGE
Washing Machines )(1 Size
\Vater Softeners Material
Bar Sinks To Main Drain
Comb. Sinks Trays To Curb
Dental Units
Drinking Fountains
Moor Drains WATER SYSTEM
Hoppers Size n
Restaurant Sinks Dlaterial ti /�/
San Traps TOTAL FEES
Urinals Fixture Fee
Area Drains Main Drain Fee
Water Leaders Storm Drain Fee
Sprinkler Valles Water Sys. Fee
Permit Fee
TOTAL FEE
RECORD OF INSPECTIO
Underground Rough..�i=
.Partial Rough..
Rough-. Complete.. - �—
\lain Drain -
Final._ A,