1328LOT NO. �C
NO. STREET
D4A PTE I16p�N FOR PLUMBING PERMIV •
b1. OF CUPERTINO .°
�p`�OV 1 1961 1u1
Date IV OU - 8 1961 195_ Permit No.
CITY OF CUPERTINO Fee $ l e
7
Application is hereby made to the City of Cupertino for a permit to install plumbing
pipes 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_ / �/9'4
Owner f /�LE��QA-I(— S
By !Cf-•,ZionNL}
CONTRACTOR, AGENT
Phone (S." _
Addres
w C/q
QI l
(=
Address/g0C'r
{ oQ y
r; 1
Approve& -7 'Y\'k, V
PLUMBING.INSPECT R
Hoppers
Size - ISIT
Restaurant Sinks I
Material 6 KLQ
Sand Traps I I
TOTAL FEES
Urinals
Fixture Fee 21,
Area Drains
Main Drain Fee I ! f0c)
Water Leaders
Storm Drain Fee
Sprinkler valves I
Water Sys. Fee / • DO
S w" soxro > I
Permit Fee
TOTAL.,, TD, is 11
TOTAL FEE S • SO
RECORD OF iy
zc
Rough .
,.tea
-2' Cupertino Sanitary
-� - -.Office Copy
-BUILDING INSPECTOR'S OFFICE . .
CITY OF CUPERTINO .
f.
.,_. �-
❑ Sewer-Connection : ; Sanitary Permit No. .. //}}//��G-o-----------
-
[ir Plumbing Final Plumbing Permit`No...l. -
..._ . O - .. .......
-................-
Lot No
Owner. or Tenant ._.l !/.. .----- -- ----e���.. ....._�. Q/'..:.... =---. .-..-.-'. ••r1� _...-.......
lJ9/Q �I
Tract -- - ----- --- --- .`� .....
Date'Connected ................ ...::. 7-----.....
---..-..._._ ..__ ......... 1941
,.;:-------
. !.
Date Final -- --- ----- ..
......................----- ....... ---------- '----....-................. 1 iL
M.
-._... .. ... ......................------ ------ -------
LUMBING INSPECTOR
_ 111 .7160-500