1578Xn wQAi'W lOT NO. IO
NO. EE
6�
AV
�O OR PLUMBING PERMIT
/JUN 8 1962:C tI F CUPERTINO
DateClY- 195=� � Permit No.
F CUP—,ERTINO Fee $
Application is hereby made t6 the City of Cupertino for a permit toinstall plumbing
pipes and/or fixtures listed on the reverse side hereof, and agrees to install said .ces
and/or fixtures ih accordancedwith:the�provisions of the Plumbing:Code of the City of ;
a
,Cupertino and all other lawj6' ap¢a
plble'thereto
4� x
Ww..« -
.. By
Cd,.,,*&Jj�CONTRACTOR AGENT .
Phone ES ' 7-
r
Address '
Approved
I PLUMBING (NSP CTO
I, -
UNITS
c"T.
Hoppers
Size /
Restaurant Sinks
Material 6,,e, -�
Sand Traps
TOTAL FEES<
Urinals
Fixture Fee =ali
Area Drains
Main Drain Fee CSS
Water Leaders ff,!-jj7'Storm_
Drain Fee
j,
Sprinkler
Water Sys. Fee /-E!L'-
Srxa&t
Permit Fee %=;ws_
TOTAL ?_'
TOTAL FEE-27-�-�
REC R OF CTION .
Partial Rough
Rough Complete 2,, Z -
Final
M
Bldg. Dept
:1 Office Copy
BUILDING INSPECTOR'S OFFICE
CITY . OF CUPERTINO
Sewer Connection Sanitary Permit No
--------------
❑ umbing Final Plumbing Permit No...... ------
. �- 74
ofNo. ---- -----(-o .._...._--
@Ownet or Tenant _
At ......... .:�.��.3C . /� . �..-- QR,� .�:2�U-0--- ' --------
Tract.._....- ............:.... ......
Date Connected .........................
Date Final ........................
- 111.7/61- 00
--.... .�. Q�.. �..-- --- --------*1----- ------ 1 .
1�. PLUMBING
E
INSPO
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