635 �I LOT NO.
STREET ,
APPLICATION FOR PLUMBING PERMIT
A' '��a3 CITY OF CUPERTINO P
D ®
1.TY
, 195_ Permit No. 63
i JAN Fee $ 45-00
0
1 �t�a 1 a{�' Q��f 'e City of Cupertino for a permit to install plumbing
9
pa land/o Ifi tir' ''lisotf tKe 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—.1
'4
v
Owner Address
By _ Address }
�I• ONTRACrOR, AGE a
'Phe App rovedWILLIAM D. ;BE�IF�ICH
on _
' - PLUMBING INSPECTOR
r
FIXTURES NUMBER 11, MAIN DRAIN
UNITS FEES UNITS FEES
Water�Aeater I / Size
Water Closets
Bath Tabs �j To Curb
Showers To Prop. Line
t Lavatories 3 I To Existing
'tchen Sinks 4M
ish Washers
aste Disposals
ash Trays STORM DRAINAGE
Washing Machines Size
ater Softeners Material
Bar Sinks To Main Drain
Comb. Sink x Trays To Curb "
Dental Units I {3
Drinking Fountains I
Floor Drains WATER SYSTEM
Hoppers Slze
Restaurant Sinks �� Material
Sand Traps �� TOTAL FEES
Urinals Fixture Fee I_/ O
Area Drains Main Drain Fee / OO
Water Leaders Storm Drain Fee
Sprinkler Valves I I Water Sys. Fee CT
11 Permit Fee I /O u
TOTAL 11 TOTAL FEE j Qd
RECORD O IN ECTI N
Partial Rough , .1
Rough Com lete ? _
Final:,}—,Q („p
Cupertino Sanitary
Officek-rIpy
BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTINO
❑ Sewer Connection Sanitary Permit N: o. ....Za� ..........
[9�Plumbing Final Plumbing Permit No. ..... ./V.._-,.;.................
Lot No. ......C?/..............
Owner or Tenant .....�-/ .........
At ......aa-
OT .................. .. ................................................
Tract ............ ti.7e&x ..............
.'Date Connected --- elll I
... . ................................................ ..............
DateTitial....................�,:��/ .7.................................................. ...........
•st
...........Q.1454------- -----------
NIBING INSPECTOR
111 7/59-500 6KU