51125 10200 Stoneydale CUP. LOT NO.
NO. STREET
yrp
aoLL
FOOF RCPLUMBING P
ERMIT
UPERTINO
wi Sanitary No.
0 Date —
Permit No
3u
w LL 74 h tJ>r tS IFee S �f�'•�
� 0
I' ati Is 9 �n permit to install plumbing
o a pipes and/or fixtures Idled on reverse
City of reverse siCupertino for a de hereof, and agrees to install said prices
I 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.
w x
� r
LL Use of Premises
00
o a Owner R._N_.—Bryan Address10200 STONEYDALEn. P.
z
o By CULL! Add3W E. EPELYN 9Q. SP.
CONTR
3 r At,TOR,AGENT .
Phone 3
w z
f 217597
o State License t. Approved
U I PLUMBING INSPECTOR
UNITS FEES UNITS FEES
Water Heate Size
Water Closets Material
bath Tubs To Curb
Showers To Prop. Line
Lavatories To Existing
Kitchen Sinks Not Conn.
Dish Washers Sewer Boxes
Waste Disposals
as'h Trays STORM DRAINAGE
Washing Machines Size
Water Softeners Material
Bar Sinks To Main Drain
Com . Sinks Yrays To Curb
Dental Units _
Drinking Fountains
Moor Drains WATER SYSTEMjj
oppers ze
Restaurant Sinks Material
an raps TOTAL FEES
Urinals Fixture Fee
rea U,ains Main Drain Fee
TY/ater Leaders Storm Drain Fee
�pnnuer Valves Water Sys. Fee
Permit Fee
TOTAL TOTAL FEE
RECORD OF INSPECTION
Underground Rough
Partial Rough
Rough. Complete
Hain Drain
Final