2732 / `i 3 9-6 I &J'cC/N.N 52G & LOT NO. /3
NO. , , STREET
AsM FOR PLUMBING PERMIT
N Q
w Z D C F CUPERTINO
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Sanitary No.
Date t MAY 7 1964
3 a 6_ Permit No C
" �/ [ �pT *�/� 00
0 ApAITY. n 0FereWERT1 i9lQity of Cupertino for a permit t��all plumbing
o` a pipes and/or fixtures listed on the reverse side hereof, and agrees to install said prices
i N and/or fixtures in accordance with the provisions of the Plumbing Code of the City of
a w Cupertino, and all other laws pplicable tl eto.
wx
LL Use of PremisesFENNT
00
Owner Address
oa
zJ2O By CONTRALTO I Address
3 < /
— W Phon
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02 State License S� Approved c
—U
PLUMBING INSPECTOR
NBER _
UNITS FEES UNITS FEES
Ir Water Heate Size
Water Certs Material
Bath Tubs -2 To Cur
Showers To Prop. Line
Lavaturies To Existing
Kitc en Si c Not Conn.
Drs Washers _ Sewer Boxes
Waste DisposaM
WagWagh Trays STORM DRAINAGE
Washing Machines Size
Water So teners Material
Bar Sinks To Main Drain
Com . Sin a rays To Curb
Dental Units
Drin ing Fountains
V nor Drains WATER SYSTEM _
oppers ize !
Restaurant Sinks Material
Sana I raps TAL FEES
rm7j �(s Fixture Fee c
rea U rains Main Drain Fee
Water—Leaders Storm Drain Fee
Sprinkler Valves Water Sys. Fee —�
Permit Fee
TOTA TOTAL FEE 0 0
RECORD OF INSPECTION
Underground Rough.. C
Partial Rough..
Rough. Complete..
Main Drain
Final...