1567' 9'74-:�- '"� �` \`\ 21,14 LOT
S �' t
NO. STREET 1 • ^•
¢PRl1 ,.N F0R',4UM8ING PERMIT
.OF CUPERTINO
t.
Date ,/MAY 24 1962` 195_ Permit No.
Fee $__.
CITY QF e YPE�i�I��
Application Is here y ma e o 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 ot�er laws applicable thereto. '
E Use of
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A
Owner k- v ,_ __ rYl
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(r, .1 �� t �'"
Address
By
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Addressi'fes
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CONTRACTOR, AGENT o
Phone'l ?9
Approve
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-�)<"1}'�,Lfr FC.
) «t.t.. PLUMBING INSPECT
.:
--FIXTURES NUMBER
MAIN DRAIN
,r
UNITS FEIiS
UNITS F�Egs
Water Heater ill
Siae -
yj:a7«
Water Closets
Material'
Bath Tubs
To Curb - �•-tit+
Showers
To Prop. Line
Lavatories
To Existing j:.�' �•:p;;
Kitchen Sinks
Not Conn. _
�• `:� =-
Dish Washers I it
SEWER 13O%E3 �• 't'�''J°,
Waste Disposals I��
�. _
�;�--•vr
Wash Trays
STORM DRAINAGE,:.
Washing Machines
Size
•�.,
Water Softeners
Material
Bar Sinks
To Main Drain _
�• .•
Comb. Sink & Traysl 111
To Curb
-Dental Units 111
Drinking Fountains 1
' •�
11
Floor Drains
11 WATER SYSTEM.
Hoppers
Resta•Irant Sinks 4°• --��
Size % :�,.';.�`:_''•
Material ��:':'.•`,.
Sind Traps
TOTAL FEES
Urin2ls
Fixture Fee
Area Drains
Main Drain Fee
Water Leaders
Storm Drain Fee
Sprinkler Vatves
Water Sys. Fee
Permit Fee
TOTAL
TOTAL FEE
RECORD OF INSPECTION T++
Partial Rough's >
'.�T�. •tii ��
Rough Complete --
Fi- L'6.
nal
/ .f
\
�s .Lice
\
19-�i- ®\3
'PIXTURBS NUMBER MAIN DRAIN;y;'
UNITS
FEES
/ o O.
IUNITSI'FEES
W r Heater 1
II
Size
Water Sys. Fee'•I
Water Closets I
SBO II
Material
TOTAL
Bath Tubs
J,'
To Curb
-,
ShowersTo
Lavatories
oo
Prop. Line
To Existing
Kitchen Sinks
Not Conn.
Dish Washers
Waste Disposal
•'•'F'z,'`";=.
Wasb,Trays
STORM DRAINAG._;�;
Wishin Ines
I Size
� ---- a _
a�N3F'er Softenprs
Material
Drain
Area Drains
Main Drain Pee I
/ o O.
Water Leaders
Storm Drain Fee
-, y -
Sprinkler Vaioes
Water Sys. Fee'•I
C
Permit Fee '��.:`' /dy.•
TOTAL
II TOTAL thL
J,'
R CO O
ECTION
! '
Partial Rougher
Rough
Final