2105 STREET—
REET LOTNO. 3)EF.T
A'LICA ON FOR PLUMBING PERMIT
� a V _CITY OF CUPF.RTINO
r '
r ° FIMAY 211963 � '. Sanitary No.
o a Date 15, off/ 196`3 Permit No' 0-S '7
wn pItYOF CU ERTI,NN� Fee $
Application is hereby made to the City of Cuperfiim foi a permit to install 'plumbing
o a pipes and/or fixtures listed on the reverse side hereof, and agrees to install said prices
'z m and/or fixtures in accordance witH the provisions of the Plumbing Code of the City of
¢ m Cupertiho; and all of laws applicable thereto.
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LL Use of P - 'ises 0� "
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i- 3 Own - Address _
ZJ
iB Address
O ONT OR,AGENT �✓
N ❑e
a o St 'W
State Lice 36- /` `� -ApprovedILLIAM D. BENEVICH
FIXTURES WIN BER MAIN DRAIN
UNITS FEES UNITS FEES
Water Heater Size
Water Closes Material
Bath Tubs To Curb
Showers / To Prop. Line r/
Lavatories �./ To Existing
Kitchen Sinks / Not Conn.
Dish Washers Sewer Boxes
Waste Disposals
Wash Trays STORM DRAINAGE
Washing Machines Size
Matta Softeners Material
Bar Sinks To Main Drain
Comb. .Sink w Trays To Curb
Dental Units
Drinking Fountains
Floor Drains %AERYSTEM
Hoppers Restaurant Sinks San Traps TA F.ES
Urinals eArea Drains in Fee dj o
Water Leaders Storm Drain Fee
Sprinkler Valves Water Sys. Fee CnC
Permit Fee .p0
TOTAL TOTAL FEE / po
RECORD OF INSPECTION
Undtrground Rough..n
--.Plrtial Rough.. .
.Rough. Complete..
Main Drain
Final -9- " .L
-Bldg, Dept.
Office Copy
BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTINO b
[] Sewer Connection Sanitary Permit No.
�mbing Final Plumbing Permit No. ...ol�[,(7 `-
I ' Lot No.
v f�.0•
I' Owner or Tenant ...__"
At .-.�0 =
- ..
Tract - -------- '
r�...- / --.._--- ----------------------------.......
Date Connected ------ --....-/-..:�JP -..._--...---.......... -....-.. 19... 3
----------
DateFinal .................._----.....-----... .c?��.:----.---.._-----..---- -----------........... 19..Sst.3
PLUMBING INSPECTOR
M 7/61-500
OFFICE COPY
ELECTRIC SERVICE NOTICE
BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTINO
..................... ................. 196.S�-
To
You are hereby authori to nnect electri service for /J
Owner or Tenant .... ,� ,,,4 -
At
No. of Wires .'.............. Size of Wires Z'.pZ--------- Size of Switch�Q��....-
Motor Load ........................:'Voltage ------------------------------ Phase
HeatingLoad ------------------------ K. W. --------- ------------------------ Voltage ..
.L._............ 110...L: New Service.__.`.".. Reconnect.._......._.
..
No. of Meters... Li..:..... R --
Heat................. 220..�.�'Three Wire................ Move Service.............
No. of Add. Meters............
Power............... .......-....... Move Meter..............
...._......- ..:. ..... .......... ...........
104 1/63.500 'ELECTRICAL INSPECTOR -
�( OPFICI7 1.
COP),
GAS SERVICE NOTICE
BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTINO t
(�
-
To 4-: `... --- ......._..... 196 ----
'
You are hereby authorized to connect the GAS service for
Owner or Tenant ........ .-..j.`�"��`"� -- �•!._.
At ... .. ----
/ New Servicee ! ------------------
No. of Meters......1.....__...... Reconnect -
Move Service .----- ......------
No. of Add. Meters -------------- - Move Meter
PLUMBING INSPECTOR
110 7/61-500
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