2359 LOT No. ✓V
Q� IOATION FOR PLUMBING PERMIT
a CITY OF CUPERTINO
E
AUG 21 1963
' 0 Sanitary No.
Q LL
0 � Date 196 ' Permit No
LL CITY OF "i +; Fee $ l�
' 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 N and/or fixtures inaccordance with.the provisions of the Plumbing Code of the City of
W Cupertino, and all other laws applicable thereto.
LL Use of Premises
00 q
> W
o Owner YpiMd rmn :a Address—
a �r1�0
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z By �`' `"'�`� na, •�= T Address -/p
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3 � 27q- gi/ l
a Phone
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W Z
o 2 _ State License �3b �y 38 Approve
.11�J YhiH153Sd3tS75f'8EffiOR
- T,IXTU frs- NUIN BLK _
UNITS FEES JUNITS FEES
Water Heater $ize
Water Closets Material L.1.
Bath Tubs ) To Cur
Showers ) To Prop. Line /
Lavatories To Existing
Kitchen Sinks Not Conn.
Dish Washers/ Sewer Boxes
Waste Disposals t
Wash Trays . AR DRAINAGE
Washing Machines —1
Water Softeners
Bar Sinks rain
Com Sink aTrays Dental Units
Drinking Fountains
r oor Drains YSTEMuppers ',
Restaurant Sinks III/
San raps TAL FEES
[duals Fixture Fee
ren rains Main Drain Fee ,Op
Water Leaders Storm.Drain Fee
Sprinkler Valves Wate[ Sys. Fee ,OQ
Permit Fee .00
TOTAL TOTAL FEE ,00
RECORD OF INSPECTION
Underground Rough---,j7--,2 2- .
.Partial Rough.. —�2 1 _
Rough. Complete..
.Iain Drain -/D^-�
Final... —
Bldg, Dept
Office G)PY
BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTINO
Sewer Connection Sanitary Permit No. .............
e�p',-Mbing Final Plumbing Permit No. .s;;p.13 .1.......
Lot Np. .....J9................
Owner or Tenant .. ....... .........-------
..... . ........... .......................
At .............:2A ci
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Tract .................................... ....................... .. ... ... 0 )e
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DateConnected ........................................r..'.+... ........................W............... 19
Date Final ........................................... ......... s
y9............
... .. ........ .
PLUMBING INSP
Ill 7/63-IM