2036 /O 67& _I�1 JCS L��� ( }OT NO. CA [
NOCJy✓�®�i_S STREET ,
APPLICATION FOR PLUMBING PERMIT
'APR 2 9 1963 UITY OF CUPERTINO
DaterxiTnr— �r!i�T:itis' 1963 Permit No. a 0 -F-
VI11 1 uI �ne �,� .••
Fee $
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.
EllUse of Premises ll ^ I
„4
Owner ��SS os'S Address L
By _ A dress/;60 T�
CONTRACTOR, ncexr
Phone L 1 O�(-C o Approve
PUI-SING INSPECTOR
r
FIXTURES NUMBER MAIN DRAIN
UNITS FEES UNITS FEES
Water Heater / Size
Water Closets j j Material j C•,�-j
Bath Tubs / To Curb j
Showers / I jI To Prop. Line X
Lavatories �, j j To Existin
Kitchen Sinks j f
Dish Washers SEWER BOXER
Waste Disposals
Wash Trays STORM DRAINAGE
Washing Machines / j Size j
Water Softeners Material
Bar Sinks To Main Drain j
Comb.-Sink&Trays To Curb
Drinks Units
Drinking Fountains, j II
Floor Drains WATER SYSTEM
Hoppers j j I —Sze —1 t , I_
Restaurant Sinks II Material Ioj
Sand Traps j II TOTAL FEES
Urinals1 II Fixture Fee I ( 'O
Area Drains j j iI Main Draih Fee j
Water Leaders Storm Drain Fee -
Sprinkler Valves I I j Wate[ Sys. Fee
I Permit Fee
TOTAL 1 /0 jI TOTAL FEE /Spa
RECORD OF TION
Partial Rough -
Rough Complete
Final