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O �4 9,0 1 lc� ,, �<..�z 0, LOT No.
NO. STREE.i'
A IC T1t FOR PLUMBING PERMIT
® CI F CUPERTINO
Sanitary No.
Date { Y�'P 1968 i965� Permit No / D
�p�n Fee$ z2LS-0
ApptPQafibn iNrret�y PiERT[ aty of Cupertino for a permit to install plumbing
pipes a�f'iil of 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.
Use of Pre ises /_ n
OwnCe/r �co�-.C-O-.�.�/ / Address/Or--l- AMfi ,
By / � r=eZ u.r-F' �✓'�`�i Address lly "
CONTRACTOR, AGENT t�l
Phone odf3-t077
State License-)-�1153v —
Approved /NK/-'-t.C' �✓i
V
I `„ PLUMBING INSPECTOR
FIXTURES
NUMBER
11 MAIN DRAIN
Hopper
UNITS1 FEES
I UNITS FEES
Water Beater
Material 619iU
Size
Water Closet
TOTAL FEES
Material /.
Bath Tub
/
To Curb
Shower
To Prop. Line
Lavatories
TO Existin
Kitchen Sink
/-S-0
Not Conn.
Sewer Box
Size
Comb.Sink&Tray I 1 II To Curb
Floor Drain
WATER SYSTEM
Hopper
Size V
Restaurant Sink
Material 619iU
Sand Trap
TOTAL FEES
Urinal
Fixture Fee
Area Drain
Main Drain Fee
Water Leader
Storm Drain Fee
Sprinkler Valve
Water Sys. Fee
/-S-0
Relief Valve
I Gas Fee
L Sd
Vac Breaker
Skimmer
_
Filter
Permit Fee
;2. of
Total
Total Fee
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I �`♦/� ��/,ir4+ oR.TI. Do. LOT NO.
�SE `r tlieITY
PLI AON FOR BUILDING PERMIT
JUN 11 OF CUPF.RTINO S"7�/
Sanitary No.
Dat Lt �...rnT'at 196 Permit No.
Cj SL
I y Ur t,u; mn II -V
Application is hereby made for a permit to f (JFc r _
a n MG story, Type S' 1 -\ Building
to be occupied only as S f r- 41 c- FAa,14 0wc tf r n g in accordance with
Plans, Specifications and Plot -Plan filed herewith. PI Ck Fee
Estimated Value of Improvements, $_3D, 00 0. � o Pee $ 90. S d
It is hereby agreed that the requirements of the Cupertino Building and Zoning Ordinances and
all other laws applicable to the construction, location, and use of buildings within the City of
Cupertino will be complied with.
Owner MA �-' fG o 11 Co
Phone Z4 1 -1f" ( 1
State License 1 97g5
Address 232x3 1-2u, co,dse S C_
Approved WILLIAM n RMNIITNrrf"H
BUILDING INSPECTOR /
S,