850 10 -410 o ( V✓/�ttill'�� LOT NO-1(7_
,T
APP N FOR PLUMBING PERMIT ri _
�JUL 26 1960CITY OF CUPERnNO
sp
CP�� —, 19, 560 Permit No. /1/
l� 11�V Fee3 ! /7
�S
m Application is hereby made to the City of Cupertino for a permit to install plumbing
po 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
Cupertino, and all oth r laws applicable thereto.
8 Use of Premises
`" Owner /Lf T-Liln,N Address .r� �a
gy �1Vc ✓in civ , C Address o�K- 41611� l,r La
n CONTRACTOR, AGENT
Phone_/\Aja -' b 'Approve-
PLUMB G INSPECTOR
UR :S NIJMBLR M DR
UNITS FEES IUNITS FEES
Water Heater J /,40 Size
Water CoseZ is — k 0-40 111 Material y°
Bath Tubs ( / ( ob To Curb
Showers 1 I ou 11 To Prop. Line ✓
Lavatories, 3 ev, To Ex'
Kitchen Sinks N Con rJ
Dish Washers
Waste Disposals T1 Iwo
Wash Trays 11 STORM DRAINAGE
Wtuhmg Machmes•T-T I ) oy 11 Size
Water Softeners Material
BarSinks T—17o Main Drain
Comb. Sink a Trays 11 To Curb
Dental Units -�
Drinking Fountains ( II
Floor DDrams WATER SYSTEM
Hoppers Size
Restaurant Sinks Material �CaI �L
Sand Traps TOTAL FE
Urinals �� Fixture Fee i
Aains IF—Dr � Main Draih Pee
Water Leaders Storm Drain Fec
Sprinkler Valves Water Sys. Fee
„ ZS Permit Fee— I ( �0�
TOTAL,. I — TOTAL FEE
R.EC RD �F INSP C O _
Partial Rough ;7
Rough Complete 4/f 0
Final .
Cupertino Sanitary
Offic Copy
BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTINO
F1 Sewer Connection Sanitary Permit No. ...............................
�KPlumbing Final Plumbing Permit No. .....� -v...........
:2 Lot No. ......./.................
Owner or Tenant
A -------
. .... ...........
AE....../ ��Iqq�77. e . -
5�2 0 ........................................................
Tract ...... ................. . .............. -----------------------------------------------------------------
Date Connected ................... '--- --.....:...e!"
.......... .------------------ 20 ........................... ..
........... .....-------
-14,
DateFinal .......................................... .. ..
.. . ..............
Wr.......................................
ill 1160-500 4wom i��G INSPECTOR