51073' baa 8�3
NO. STREET
wZ TION FOR BUILDING PERMIT
r ° I OF CUPERTINO
0 < LL Sanitary No.
S" �.? 4966
F0 Uate _ .46,F Permit No.
0 r Application is hereby made for a permit to VV, � L>
U) a C 0Fstoq, .fa
XR11We o ��,�,,, >�. "o ys� Building
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I to be occupied only as 0 i ,,w �F f'o et t in accordance with
0 0 Plans, Specifications and Plot-Plan filed herewith. PI Ck Fee
t ; Estimated Value of Improvements,$ 3. O G o Fee$ IS.6
i J It is hereby agreed that the requirements of the Cupertino Building and Zoning Ordinances and
* Z all other laws applicable to the construction, location, and use of buildings within the City of
' o Cupertino will be complied with.
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— � Owner (1, T32 at tv Address 2247_L C44.UDys;rr
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a By Address >is
0Phone_�+� .s'76 a'7 Approved
1 State L icens 3 PP BUILDING Nftf"Ll OR ✓
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o LOT NO.
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Im1iI �OR PLUMBING PERMIT
a 1� "OF CUPERTINO
fQ /JUL 26 1966
a 0 Sanitary No.
Q 4 f�
o � Date rCj�T M1''d96� Permit No C
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< CITY I� Fee$ J
O 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
I 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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a w Use of Premises
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o a OwneryQ--� ` +� Address_�Zyl7. '�
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CONTRACTOR,-7
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o s State License r r 3 7 St Approved
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-0 PLUMBING INSPECTOR
FIXTURES INfBER —NrA=RAIN
UNITS FEES UNITSI FEES
Water Heate Size
Water Closets Material
Bath Tubs To Curb
Showers To Prop. Line
Lavatories To Existing
Kitchen Sinks Not Conn.
Dish Washers 11 Sewer Boxes
Waste Disposals '
Wash Trays STORM DRAINAGE
Washing Machines Size
Water Softeners Material
Bar Sinks To Main Drain
Com ..Sinks Trays To Curb
Dental Units
Drinking Fountains
Floor Drains WATER SYSTEM
Hoppers Size
Restaurant Sinks Material
San Traps TOTAL FEES
Urinals Fixture Fee
Ara Drains Main Drain Fee
/ A Storm Drain Fee
rinklrr Va lvcs Water Sys. Fee /, 00
Permit Fee 0
TOTAL TOTAL FEE
an
RECORD OF INSPECTION
Underground Rough
Partial Rough
Rough. Complete
Main Drain
Final