12697O. No. `1 LOT NO.
Txe ...
-� JVOF
OR PLUMBING PERMIT
tSEP 2 6 1961 `CUPERTINO
r,
DateCIT RTIN0195_ Permit No.
Fee $ bi
Application is hereby made to the City of Cupertino for a permit to install, plumbing
pipA.and/or fixtures listed on the 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.
Use of Premises
a
Owner K/PGjzy f4om :L: Addrewl�
By Lr C— — Jc�/v H$ ,:AddressCONTRACTORAGENT pprove
FIXTURES
NUMBER
MAIN,!) OR
UNITS
FEES
!Aul, '- hi}` UNITS FEES
Water Heater
/
I ,Sae " I '• 41
Water Closets
c3
'.Material! �'LS'
Bath Tubs .,{
j
ToCur,p' . P I
Showers
j I
To Prop. Line x �(
Lavatories
To -Existing - I ++
Kitchen Sinks
/
No 0:141 �*�
Dish Washers
` ' ���
Waste Disposals
Wash Trays
II STORM DRAINAGE
Washing Machines I
/ . I
II Size ';�i I,'> I
Water Softeners
-
Matciial
Bar Sinks;-
•'
To Main Drain
Comb. Sink wTraysl
I
j.,
11 To Curb I_ I
Dental Units
Fountains I
rea
Sorinkler Valves I "' I - •wate[_bys. ree I r
" -3 • .p Cupertino Sanitary.
_ Office Copy
BUILDING INSPECTOR'S OFFICE rt `
CITY OF CUPERTINO
F-1SSewer Connection
anitary Permit No- ----- -.��.r •............. '
_•Plumbing Final Plumbing Perinit No...l.-rZ._..:......... .
/ Lot No
Owner or Tenant --- -� D.(A !'lP/.y
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PLUMBING
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