1214 ,�D J/O /"EP,PrPTF'E'Y L/3NF LOT NO.—
NO.
O.NO. STREET
Ti" FOR PLUMBING PERMIT.--.
OF CUPERTINO .
{SEP 12 1961 �( •
Date - 195_ Permit NO.
CITY OF CUPERTINO Fee $ /9-
11 Application is hereby made to the City of Cupertino for a permit to install plumbing
n pipes and/or fixtures listed on the reverse side hereof, and agrees to install said prices
band/or fixtures in accordance with the provisions of the Plumbing Code of the City of
U ,Cupertino, and all other laws applicable thereto.
se:of Piemises .Pl'SiDrn:c«
Y
1�O vner oarri Atdn f Address o Ct, '
B `t, ,
� y= } /iy Fia r a- Address
CONTRACTOR, AGENT a '�
t Phone'i'�=/,�- �F-k/// _ Approve .
'4+' PLUMBING INSP CT R ,
FIXTURES I NUMBER MAIN.DRAIN
I UNITS I FEES ' JUNITSI FEES
'Water Heater I Size ,•s #i) '
%Water Closets 3 I Material•[•
-,BathTubs. To Curti'
Showers i- 2 To Prop. Line
Lavatories 3 : To Existing
Kitchen Sinks - 'N- on /
Dish Washers • ' IBEWER BOXESi I2S0
Waste Disliosals 1 -
Wash Trays STORM DRAINAGE
Washing Machines - I I-•Size
Water Softeners" �. Material •,"'•.,:,I
Bar Sinks - To, Main Drain I;•'
Comb. Sinks Trays ' ' ll, To Curb I_6i
Dental Units `
'Drinking.Fountainsl 1. '.II,. ,'Ir
Floor Drains :. 1� WATER'SYSTEM•
h
Hoppers :,;'ISize
Restaurant Sinks I _ I-Material Gn�V•:°``. :.
Sand Traps_ '• :TOTAL FEES'
Urinals - 11 .Fixture,Fee • I -y,
Area Drains I I I - Main Drain.Fee in Fee
Water Leaders II= Storm Dra ,l':
Sprinkler Valves I% Water Sys. Fee „�;�'(1u',J
Permit Fee '�,�1 /.A'd1,L)
TOTAL I, "' TOTAL FEE
REC RD OF I
Partial Rol ,h /, it":i:�Au•<<+:'I
Rough Comp
l
Final +�`-
- 'Cupertino Sanitary o -
Office Copy
•" BUILDING INSPECTOR'S OFFICE
CITY OF,.CUPERTINO '
Sewer Connection � � �U,2 ._ y -Permit �'� �- --
�' ❑ - Sanitar Permit No'."::.- ,!�- .•
lambing Final. Plumbing, Perin t No?;--�d .y.�-....-.-i.
E
Lot o. 17 ,
,.OwnerotTenant
Tract
................. _ ____ -
v' v
..I^^n��--r�/� /
Date Connected,"-....' 9,�ti`� ... .-.... 19
Date Final --- _ ._......../rte-1 _ .._....._--.--------
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