51001.4LOT NO,
NO. STREP.I'
ASC OR PLUMBING PERMIT
Tf&
CUPERT[NO
:mlCary NU.
Datei�a2. 1968 196,Fr Permit No S/
��] 'n�� Pee $�6 S"J
App;, MY is@rreb0LWE T1N0y of Cupertino for a permit to install plumbing
pipes an`c7%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.
Use of Premises
Address/(2 - - �R
Address �- ��
CONTRACTOR,AGENT �J—
Phone R -607%
State License a.3 -'9.a.17"
Approved
\ `' PLUMBING INSPECTOR '�
FIXTURES NUMBER MAIN DRAIN
UNITS I FEES 11 UNITS I FEES
Shower /
To Prop. Line ✓
Lavatories
To Existin
Kitchen ink
Not Conn.
Dish Washer
Sewer Box
Waste Dispos
Wash 'Cray
STORM DRAINAGE
Washing Machine
Size
Water Softener
Material
Bar Sink
To Main Drain
Comb.Sink & Tray
To Curb
Dental Unit
E
Drinkin Fountain
Floor Drain
WATER SYSTEM
Hopper
Size /" I / I
fixture Cee
Area Drain
i 11
Permit Fee I a • 0 0
Total i /( Total Fee IAto, S. 0
/D
NO.
APPLICATION
Application is hereby made for a permit t
a n N E story, Type t—
/S7(
LOT
BUILDING PERMIT
IPF.RTINO ��/� 940
Sanitan• NO.
Permit No.
E eec%I
Building
to be occupied only as 51 ny lc pgk , ly 47 we 111 n� in accordance with
Plans, Specifications and Plot -Plan filed herewith. Pl Ck Fee
Estimated Value of Improvements, $ .30/000. 00 Fee $ 90. 5'0
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 i`�W('/L.. W 00 Address 2383 Pea ea.dcs S.0
By
I - VI & I
14 State License 1 S >s: '
Approved WILLIAM 0. BENS+ICH
BUILDING INSPECTOR