1543LOT NO.
NO. STREET - -
FOR PLUMBING PERWT
C , F CUPERTINO (,�26 7—y>
MAY 14 1962
\ Date , 195_ Permit No.
CITY OF CUPERTINO Fee $ s
(_ Application is hereby made to the City of Cupertino for a permit to install plumbing
a3 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 applicable thereto.
Use of Premises
Owner Address
9 _
By Address
CONTRACTOR, T
Phone �j(/�a-�,� Approved
/ PLUMBING INSPECTOR
UNITS
FEES UNITS FEES
Water Heater I
Size
Water Closets
Material
Bath Tubs j I
jI To Curb
Showers
To Prop. Line
Lavatories
Kitchen Sinks I j
Dish Washers I
To Existing
II NqCC n
II8EWE 6x a
Waste Disposals I I
II
Wash Trays I I
II STORM DRAINAGE
Washing Machines I I
II Size
Water Softeners
Material I j
Bar Sinks I I
Ij To Main Drain I
Comb. Sink & Trays I I
II To Curb
Dental Units
Drinking Fountains) I
II j
Floor Drains I I
�� WATER SYSTEM
Hopp; rs I I
II Size I j
Restaurant Sinks I I
II :Material
Sand Traps j I
II TOTAL FEES
Urinals j I
j� Fixture Fee I—,'),So
Area Drains I I
Water Leaders I I
II Main Drain Fee
II Storm Drain Fee
Spri ler Valve I I
II Water Sys. Fee
I Permit Fee 0-0
TOTAL I
II TOTAL FEE ,
RECOR
I CTION
Bldg- Dept.
Office Copy
BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTINO
Sewer Connection Sanitary Permit No.------G?/--Tv--/--
Ll,. -Plumbing Final Plumbing Permit No.
................
LotNo. ... .................... ......
Owner or Tenant ... ... ----- ------- .. ...................... --------------------
At 10-- -
ap --- -------•----- -- ------ - ----------- --------------------------------------------------
--- / -- --- -----------
Tract ---------------------- --—
------------------------- ---------------------------------------------- ............
Date Connected --------------- --------------- %
- ------- ..— ..... ----------------------------------------------
DateFinal ----------------------------------------- ---------- - ------------------------ 19
............. --- ----
INSPECTOR
`CTORG ---- -----------------------
111 7/61-500