2502 L'.,L LOT NO. /0/
NO. Q EET.
L• P1j1 Ot(JR PLUMBING PERMIT
d ® CI �F CUPERTINO•
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x g NOV 13 1963 Sanitary No.
' LL a
0 a Date �Z NO� 196-3 Permit No
LL CITY OF CUPERT"�1aP Fee $ 610
° 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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Use of Premises �ESiOL.✓cF
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3 Owner Gt]Al-W G/2iiwn0 Address
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cJLE GQ Address /ylr/!� //S/.f/
° CONTRA TOA, AGENT .
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- 0 Phone lZ�51' — Zti 2 0
au State License �6G99� Approved
PLUMBING INSPECTOR
UNITS FEES UNITS FEES
Warm Heater ' Size 4
Water Closets ,3 Material Or
Hath Tubs To Curb
Showers To Prop. Line
Lavatories - To Existing
Kitchen Sinks Not Conn.
Dish Washers Sewer Boxes
Waste Disposals
Wash Trays STORM DRAINAGE
Washing Machines Size
'%Xlater Softeners Material
Isar Sinks To Main Drain
Comb. Sink s Trays To Curb
Dental Units
Drinking-Fountains
Floor Drains WATER SYSTEM
HoppersSize 21/
Restaurant Sinks Material
San—Traps - TOTAL FEES
Urinals Fixture Fee 2,10
Area Drains Main Drain Fee 21 00
Water Leaders Storm Drain Fee
Sprinkler Voives Water Sys. Fee .00
Permit Fee 2,v0
TOTAL y TOTAL FEE /7,00
RECORD OFINSPE ION
Underground Rough... -gi6
l.partial Rough.. 22 -,3.
�Roughl. Complete.. - /
N'Iain Drain
Final._