2476 ' LOT NO.
FINOV
� EE e �
PLI' ATION EOR PLUMBING PERMIT
` CI OF CUPERTINO
EZ 5 9963
x otlpl�jSanitary No.
3oLL C z
a Date C� C " -� _IQ(i— Permi[ No �_
U \YI(Vl
i a
—T r--?
- Fee $ �?.5 i Cl U
' o Application is hereby made to the City of Cupertino for a permit to install.plumbing
o a pipes and/or fixtures listed on the reverse side hereof, and agrees to install said prices
Z m` and/or fixtures in accordance with the provisions of the Plumbing Code of the City of
a w Cupertino, and all other laws applicable thereto.
a Use of Premises, . .G•.�../"
00 l/
3 Owner � �����/ rT 7.('i�vtf,!/ Address
0 < v ' /
z By % (� �. -J! i,t�
0 Address - i. /..(. .•e c;' .l Y
3 C.(y° 3"z�
– m Phone
wz
W w
ao State Licensey " Approved
�7 U rnvro�rrnw
I/ T PLUMBING INSPECTOR
—�eTUR LIN BER
UNITS FEES JUNITS FEES
Water Heater Size
Water Closets rZ Material
Bath Tubs To Cur
Showers To Prop. Line
L vatories To Existing
Kitchen Sinks Not Conn.
Diss Washers Sewer Boxes
Waste Disposals
Wash Trays STORM DRAINAGE
Washing Machines u2 Size
DUater Softeners Material
Bar Sinks To Main Drain
Comb. Sink m Trays To Curb
Dental Upits '
Drinking Fountains
I oor Drains WATER SYSTEMI _
appers. Size
Rest;mrant Slnks Material
S IT't r' ars TOTAL. FEES
anal% Fixture Fee
Area rains Main Drain Fee
Water Leaders Storm Drain Fee
Water Sys. Fee /
Sprinkler Vnwcs y
Permit Fee
TOTAL. QO TOTAL FEE -
RECORD OF JNSPJTION
Underground Rough...I lO 3 &.
.Partial Rough..
Rough: Complete..
llnin Drain �
Final...
Bldg. Dept
Office Copy
BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTINO
❑ Sewer Connection Sanitary Permit No. .ZZL-4
................ .............
Plumbing Final Plumbing Permit No(;�?--il-7.4.......
Owner or Tenant ........ . .......'Y.............. .
.... . .. --------
........ . ................
At ..... --—------I------------------ ✓ -------- .... ..........
Tract ................................................. .......... .... ............................................
Date Connect .........................
Connected ............ ... . ..................................
DateFinal ................................................ -- ------ - - ............ .......
------------ .... ..... .
PLUMBING' INSPeOR '
111 7/63-1.M :2r
FICE COP)" `
ELECTRIC SERVICE NOTICE
BUILDINGS' INSPtCTOR'S OFFICE
CITY OF CUPER O {/
�.
.:................ 196:.....
To
You are hereb au eed to connect electrical e jc r
Owner or Tenant .. .-"..1/'.: P{l-Q! . .. <.........
-.. ...... :...........
t G r Y ;.,
At ........ ..CzC: :J:........:................... ..q....... k3:.... :....' .. ....... ..............
No. of Wires ...... ......... Size of Wires ........:y..... Size S�ait� .-IOnf
I'
Motor Load .......................... Voltage ................................ Phas ..................................
HeatingLoad ........................ K. W. ................................. Voltage ................................
110..�/New'
lRot............_
No. of Meters. Lig1 .Heah . ..... .... _.
Move Service............
No. of Add.Meters............
Power............... hree B e....... jf f Move Mgpr..............
ELE R CAL INSP R ' /1
i 104 7/63-500 C/ .