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2359 (2) LOT No. ✓V Q� IOATION FOR PLUMBING PERMIT a CITY OF CUPERTINO E AUG 21 1963 ' 0 Sanitary No. Q LL 0 � Date 196 ' Permit No LL CITY OF "i +; Fee $ l� ' 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 i N and/or fixtures inaccordance with.the provisions of the Plumbing Code of the City of W Cupertino, and all other laws applicable thereto. LL Use of Premises 00 q > W o Owner YpiMd rmn :a Address— a �r1�0 ZJ z By �`' `"'�`� na, •�= T Address -/p _ o 3 � 27q- gi/ l a Phone — N W Z o 2 _ State License �3b �y 38 Approve .11�J YhiH153Sd3tS75f'8EffiOR - T,IXTU frs- NUIN BLK _ UNITS FEES JUNITS FEES Water Heater $ize Water Closets Material L.1. Bath Tubs ) To Cur Showers ) To Prop. Line / Lavatories To Existing Kitchen Sinks Not Conn. Dish Washers/ Sewer Boxes Waste Disposals t Wash Trays . AR DRAINAGE Washing Machines —1 Water Softeners Bar Sinks rain Com Sink aTrays Dental Units Drinking Fountains r oor Drains YSTEMuppers ', Restaurant Sinks III/ San raps TAL FEES [duals Fixture Fee ren rains Main Drain Fee ,Op Water Leaders Storm.Drain Fee Sprinkler Valves Wate[ Sys. Fee ,OQ Permit Fee .00 TOTAL TOTAL FEE ,00 RECORD OF INSPECTION Underground Rough---,j7--,2 2- . .Partial Rough.. —�2 1 _ Rough. Complete.. .Iain Drain -/D^-� Final... — Bldg, Dept Office G)PY BUILDING INSPECTOR'S OFFICE CITY OF CUPERTINO Sewer Connection Sanitary Permit No. ............. e�p',-Mbing Final Plumbing Permit No. .s;;p.13 .1....... Lot Np. .....J9................ Owner or Tenant .. ....... .........------- ..... . ........... ....................... At .............:2A ci .....................*.......:...... Tract .................................... ....................... .. ... ... 0 )e ..................... ....................... DateConnected ........................................r..'.+... ........................W............... 19 Date Final ........................................... ......... s y9............ ... .. ........ . PLUMBING INSP Ill 7/63-IM