2106 LOT NO. t2�2
NO. STREETc
d ® APPL'ICA:T,ION�FOR PLUMBING PERMIT
CITY[OP CUPERTINO
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r o MAY 23 1963 sanitary No.
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0 j Date 4 oZ/ , 1963 Permit No r'f / D �O
w w CITY OF CUPERTNO Fee $ .�o
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� Application is hereby, made to the City of Cupertino for a permit to install plumbing
oa pipes and/or fixtures listed on the reverse side hereof, and agrees to install said prices
> r- and/or fixtures in accordance with the provisions of the Plumbing Code of the City of
a w Cupertino, and all other s applicable thereto.
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w Use of Premises
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NT OR AGENT
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aw. t �.3C� O773r➢S� i _ A Approved D. BENEVICH
State License pp
0 I PLUMBING INSPECTOR
FIXTURES NUMBER MAIN DRAIN
UNITS FEES UNITS FEES
Vater Heater / Size
sX'ater Closets 3 Material & /
3ath Tubs / To Curb'
Showers / To Prop. Line v
Lavatories ' To Existing
Citchen Sinks / Not Conn.
Dish Washers Sewer Boxes
Waste Disposals /
sX/ash Trays STORM DRAINAGE
Nashing Machines / Size
Mater Softeners Material
liar Sinks To Main Drain
-omb. Sink a Trays To Curb
Den(al Units
drinking Fountains
floor Drains WATER SYSTEM I
Hoppers Size
Restaurant Sinks - Material
San .Traps TOTAL UES
Urinals Future Fee //. 00'
Area Drains Main Drain Fee ;2 Q p
Water Leaders Storm Drain Fee
�prinkler Varves Water Sys. Fee QO
Permit Fee d o
TOTAL / TOTAL FEE _Q
RECORD OF INSPECTION
Underground Rough. --5 3
.Partial Rough.. �'—,S= 3.
Rough. Complete..
-1, in Drain
Final... ��'�-�`� r _
Bldg. Dept. -
Office Copy
BUILDING INSPECTOR'S OFFICE
s CITY OF CUPERTINO
Sewer'-Connection
� Sanitary Permit No. ....... /3/�-----
L�r'r bing Final .Pl=bin Permit No. 104p--._.-
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Yl Lot No. :4G� >�
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- b Owner or. Tenant .-..:.-.
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At . .... .
Tract -----------------.
Date Connected -----------------------------------
DateFinal .....--------...-------V------------- G ------- .....----------------------------:--- 1940 .
--------- - - - -------.......----
.._... ----
PLUMBING INSPECTOR
111 7/61-500 ' „
A
Al GAS SERVICE NOTICE OFFICE
COPY
BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTfNp
.... --- --------
------------ ................... 196.�
TO
You are hereby authorized to connect the GAS service for
Lttt
Owner.or Tenant *. ...... ... ..............
..
.......... ..... .................................................
... .. .................
A t"� ...
New Service ..../ ...................
............
No. of Meters -Reconnect ..............................
Move Service ........................
it No. of Add. Meters .......... Move Meter ............. ......
..........
PLUMBING INSPECTOR
110 6/63.500
%",OFF!CV COPY - '
ELECTRIC SERVICE NOTICE
BUILDING INSPECTOR'S OFFICE
CITY OFCUPERTINO
To p +
G/. 77 2.Q....---- ------ 196.3
I
You are hereby authoriz to onnectt elect 'cal service for
Owner or Tenant _
n
At .: ...fes ..-- -- ---- .... . .. . . ..........----- -- -- -
..... ...........................
No. of Wires .............. Size of Wires r�.. ------- Size of Switch .
MotorLoad ......................... Voltage ------------- ---------------- - Phase
..................................
Heating Load -- K. W. ........................
.......... Voltage
No. of Meters..... ----„ Light................ 110.:v New Service..[."...... Reconnect.._..............
.�....
No.of Add. Meters............ Heat................. Three Wire................ Move Service....
e. :......
, - _ _
Power............... '� e............... ove..Metes.....__....
1041/63-500 _ ELECTRICAL INSPECTOR,