1595 (2) . . Qr �✓ �E7¢C�� Y�'C L Lr r N l�
NO. STREET - -
V09WRIMFOR
PLUMBING PERMIT
OF CUPERTINO
JUN 20 1962
Date I 1 R 10j62- . t��, 195_ Permit No' /y7
(� CITY OF CUPERTINO 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.
"d8 Use of Premises
:7
Owner '\ L � /7�Aw6Addre 4N 'y �� AddresstRCONTRACTOR, AGENTPhone ��L 8' Approved
PLUM
FIXTURES I NUMBER 11 MAIN DRAIN
I UNITS I FEES 11 JUNITSI FEEs
Water heater II Size ll.
Water Closets I Material
Bath Tubs To Curb
Showers I To Prop. Line
Lavatories To Existing
Kitchen Sinks / I No on
Dish Washers
Waste Disposals
Wash Trays II STORM DRAINAGE
Washing Machines Size
-Water Softeners I Material
Bac Sinks.,. II To Main Drain'I I
Comb. Sink a Trays) To Curb
Dental Units
Drinking Fountains) I II
Floor Drains WATER SYSTEM
Hoppers I I I Size —(3��1---
Restaurant Sinks II Material
Sand Traps TOTAL FEES
Urinals I I Fixture Fee I �'
Area Drains I Main Drain Fee ( �p
Water Leaders I Storm Drain Fee I
Sprinkler Varves I II Water Sys. Fee I / - 06
_ I II Permit Fee I / QO
TOTAL TOTAL FEE
RE O D OF ION
Partial Roug� .�
Rough Complet
Final
Bldg. Dept.
Offi<e.Copy
BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTINO
❑ Sewer Connection ✓�//"'//
Sanitary Permit No ------�v&-,.........
ZYPI'umbing Final Plumbing Permit.No.
' • ' Lot No. .....9.5.-___.......
Owner of Tenant ... .. ........... -... .. ----... .........
.,....- '
•� (a.At ---
_
Trail .,,. _.
DateConnected ......--........... . . . . _1
G ------------------ ------ 19
Date Pinal"'-=--------------------------------- _�..f l-..----.........-----
.. 19--G.
........
- -
PLUMBING INSPECTOR
111 7/61-500 "