1389 n ti. � •
LOT NO. Il
No. STREET -�
LI 1 PLUMBING PERMIY" '
CI!P
VAN 2 5 1962 PE r, ,a
Date...._r_r�N?!!P.Y..._?. 196.x.-. " Permit No. ....__-- .;'
• y; ................
CITY OF GUPtn-Tia/iR Fee $
CUPERTINg
\ Application is hereby made to the City o 9anta:C91ara for a permit to install plumbing
t ;
pipes and/or fixtures listed on the reverse side hereof, and agrees to install said pipes
•� and,/or fixtures in accordance siith the provisions of the Plumbing Code of the City of
Samara; and all other laws applicable thereto.
Use of Premises .. /.l.L:SLO /vf
t .. ..... .. .. ................ ....... .......................................
-
Owner S.&(L.l1AKf... Address .,. dA/_
By RIA4.... - . Address...�A .R.. .GL_:.. G�l�(F_.
CONTRACTOR, 'AGENT t" 4 {Q
-lr.-�/............ e T
' / bbonc .._......lQ.....Y ....- .. . - j M C N ECP ;
p ov �
P INS R
FIXTURES NUMBER,"
UNITS I FEES 11 'y:..r• 1 %, I1 111 U FITS I>FEES
Water Heater
Waterlosets .Material
Bath Tubs :To'Curb 1.('�'I(•' : .I.
Showery 1 I, ' II °To Prop; Line. I w.✓ I
Lavatories I ,2 r I .To.Existing
Kitchen Sinks I ( ( _ ,No n 4-tt.
Dish Washers I 'f,'; r,I'=„ �,rII,._s� .�'.1.'- It'
Waste Disposals ,f' y,I yr. -_ L-�:+ ,' '` }, 'S'I• , I.
Wash Trays II -j I b( STORM DRAINAGE
Washing Machines / r,,� I11`- II'Size
Water Softeners . I I I :Mateiial.g�FS: r'r' -•' I
Bac Sinks ,.It: =4-.I'1 � II.J6 Main Drain? ; ,tiI
Comb. Sink&TraysII ;To Curb 'I. I
Dental Units •.I i y II ._i
Drinking,Fountains l�. '; II
Floor Drains I II WATER SYSTEM
Hoppers 'Siler+fi,. ;� ' ' ✓}
Restaurant Sinks I I Material �p�y.il ✓I -
Sand Traps I - ^ x: I .�f iXOTAL FEES t
Urinals I='•'++:F,I '- > II Fiztirrea'Fee /3+5`C1
Area Drains I"r:*` ;1 ,,,• Mairiorain Fee I' j,jo
Water Leaders • �: 'Irst""i%,I=SEorKDraio Fee I
Sprinkler Valves I -�" •II
'� '.Wates`Sy3�jFee I j,_t;p
r'Fwr2Pei'ni;tjFee+g,.:
TOTAL % I: _, , , II TOTAL)FBE
RECORD OF INSP CTf ^1;
Partial Rough
Ro Ctimpl tea Z-'-
Fina_
ry
5.1 Cupertir. Sa��PY .
' BUILDING' .INSPECTOR'S OFFICE
-CITY OF CUPPRTINO '
❑ Sewer Connection'. Sanitar• Permlt- No. ...bf. ....------'
�Plumb'ing Cnialrz," Plumbing Permit No. la '/
..Lot No 1
O«ner.or Tenant - - - -- '--- . ....O�
w
Ate. ' �'p� e
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Y Y y~ ♦ .•I.
19
Date�Coanectedz ' +3 �` (p
Date Final , --
4_ niHIN 11 r.c,rOR:-'.
lit 1/60.500
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