1525 C�--,?(, 6,
�Cs.-5��1rL - LOT NO. ZW
NO. STREET
® 1 R PLUMBING PERMIT
C Cr
cCUPERTINO
AY 111962 •
Date �' - 1 Permit No. l o �d
0
CIT CP CUPERTINC pee 2 7 bis
-Application is hereby made to the City of Cupertinolfor a permit to install plumbing
p pipes and/or fixtures listed on the reverse side hereof, and agrees to install'said prices
and/or fixtures in accordance with the provisions df the Plumbing Code of the City of
Cupertino, and all other laws applicable thereto. d -
8 Use of Premises-APARTMENT
72o 4 cPw��ve�
PHILIP RAFALOW,,JI C:: h 0
Owner Address'
By, �' I,` p / p
Address
GENT
W Curxbin�.-J�xc
rl$IICI1�6ary@iA�TOR, AI
Pho�iEmpbell, California Approve P
,Phone"377-566y o wcuarerNc rNSEEcroa J
j
!v
SURES NUMBER . MAIN DRAIN ,
UNITS•I FEES II UNITS FEE
.Ware, Heater / I / da II Size , I/ I II'
Water Closets J /�/>"-,I Material C, 1• .I -I;
Bath Tubs /�•-." y° - To Curb _
Showers •_' To Prop.:Lin
Lavatories Ex' �k
Kitchen Sinks t No Con
Dish Washers _
Waste Disposals .;r..:
Wash Trays STORM DRAINAGE•
i!,! in Machines Size
Water Softeneis �- J1 Material j
a Sinks To-Main Drain
Comb,.S;nk a TraysTo Curb;' .. t 1;
•Dental Units .'I • ' , '
i
Drinking Fountains)
Floor Drains WATER SYSTEM
Hoppers Size
Restaurant Sinks `; Material
Sand Traps TOTAL FEES -; oN
Urinals FixtureFee jy .
Area Drains Main Drain Fee vv
'Water Leaders StormrDrain Fee
Sprinkler Valves Water -Sys. Fee I cl-�-
Se Permit Fee w
TOTAL �t TOTAL FEE . sx�_
O
Partial Rough ' ,y7 L ' -
Rough Com 1 � •
Final 11�
-.—..Bldg.Dept. ,
t.f Office Copy
BUILDING (INSPECTOR'S OFFICE
CITY CSF C,4ERTINO
0
Sewer Connection 4 o�S S
Sanitary Permit No. ...-.--_.... ...
._----. ......
Plumbing Final Plu bing Permit No.
.... Lot No. .........:. .-----
Owner or Tenant'----------------'
At -------
Tract ......................-----...---...----...------.......... ... � _
. l�
Date Connected ...... ...:.......-------
- -- ^ -- 'INS ..--....._..... - -- ...
Date Emalrr- ..........................p! c ' �' ^fie
19.
l y ti's`.. `
�• PLUMBING .INSPECT R "�