632 17` ORr LOT NO.
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APPLICATIFOR PLUMBING PERMIT (/0/Q)
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i�6� Cf�ITY OF CUPERTINO
Date --rTlw1n 195_ Permit No. �
.I-- 11111 V DO
V) Fee $--4
Application is hereby made to the City of Cupertino for a permit to install plumbing
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 other laws applicable thereto.
8 Use of Premises'' /�-/y
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y Owner Address
By— A� Address
"� CONTRACTOR, ncE
Phone Approve ILLIAM D. SENFyi H
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PLUMBING INSPECTOR
$ FIXTURES NUMBER MAIN DRAIN
UNITS FEES UNIT51 FEES
. Water Heater / i1 Size
W�ater��Clusets 1 2. Material e
-Ha" th, s To Curb
i MO.- rl To Prop. Line
l Lavatories •Z To. Existing , ��ap�.�y
KitcHen'Sinks - Con . kel
n2 " IG/'n
Dish Washers /
Waste Disposals
Wash Trays STORM DRAINAGE
Washing Machines 1 1 11 Size 1
Water Softeners Material
Bar Sinks To Main Drain
Comb..Sink &Trays To Curb 1
Dental Units 1 it —CA I
Drinking Fountains) I II 11
Floor-Drains 1 1 1 WATER SYSTEM
Hoppers Size /
Restaurant Sinks1 1 11 Material S_ j 1
Sand Traps TOTAL FEES
Urinals 1 Fixture Fee
Area Drains Main Drain Fee / OO
Water Leaders Storm Drain Fee
Sprinkler Vanes Water Sys. Fee p O
�/) 1 Permit Fee �I p
TOTAL II TOTAL FEE 3 Q rJ
R CO D OF NS ECTION ,
Partial.Rough '
Rough•Com let �, �—
i Final '•' 3 (pp
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BUILDING INSPECTOR'Si OFFICE
CITY OF CUPERTINO
❑ Sewer Connection Sanitary Permit No. ....
Plumbin Final `
Ek'Plumbing Plumbing Permit No. .....��'.,
....... .......
Lot No. .........
'�D.............
Owner or Tenant .......N. r !.. ...1%................_..
At ......<4�.9. .Q.7.z. ......�'.-moi. . ... ....... .
Tract ....... ... ..... ..:..................... .... ...........:...:.....................
Date Connected ............... .�a?. ... .........---................ ... ............ ...... ._.. ..
19..........
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Date Proal -..:...:.'.....`................ .............._...-..........ALUMBINGINSPECTOR
19..-��.0
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171 7/59-500 x'
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GAS SERVICt-NOTICE 'e
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BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTINO ° //'�__�
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To
You are hereby aut�oi• to connect the GAS service for
i. Owner or Tenant ...J;. ,.!rs ---'-- - -- ..................... .. .. ..................
a ,
At ----- 77 :..� d ��.... ...... .... ................
, ' •�_' - New Service ' '•""
.
< No. of Meters.--- --::.......... . : Reconnect ..............................
. . Move Service .
No. of Add. Meters .......... ... Move Meter.............,......
LUMBING/
' 110 6/59-500 � � f\ - Ar,°" v°