51121NO. STREET /]
z ;P9 "A _P.L� CATION OR BUILDING PERMIT
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° < IDEC 2 2 1965 Sanitary No.
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w Uate 196_ Permit No,
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CTpsp�e�araPermit to
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a story, Type �r
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be occupied only as
' in accordance with
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Plans, Specifications and Plc -/Plan filed herewith. P1 Ck Fee
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Estimated Value of Improvements, $3®O —'
Fee $ 3 e!�
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It is hereby agreed that the requirements of the Cupertino Building and Zoning Ordinances and
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all other laws applicable to the construction, location,
and use of buildings within the City of
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Cupertino will be complied with.
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Approved
BUILDING INSPECTOR
State Licenses
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WATER DEPT.
AUG 29 1971
Lot No.
APPLICATION FOR PLUMBING PERMIT
CITY OF CUPERTINO
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Sanitary No.
Permit No.
Fee $ -3 ,j'O
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.
Use of Premises
Owner
By
Phoneys --5'3 ;'-�'3 c ;'
State License Ay ;?- 613
Address
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WILLIAM D. BENr:-:VICI
Plumbing Inspector
Filter
I .7�✓y` O' r Permit Fee y= I
LTotal Totat Fee ea 3Z
FIXTURES NUMBER
MAIN DRAIN
Units Fees
Units I Fees
Water Heater
Size
Water Closet
Material
Bath Tub
To Curb
Shower
To Prop, Line
Lavatories
To Existing
Kitchen Sink
Mntr^nn
Dish Washer
Waste Disposal
Wash Tray
STORM DRAINAGE
Washing Machine
Size
Water Softener
Material
Bar Sink
To Main Drain
Comb.Sink & Tray
To Curb
Dental Unit
Drinking Fountain
Floor Drain
WATER SYSTEM
Hopper
Size
Restaurant Sink
Material
Sand Trap
TOTAL FEES
Urinal
Fixture Fee
Area Drain
Main Drain Fee
Water Leader
Sprinkler System
Water Sys. Fee
Vac Breaker
Skimmer
Filter
I .7�✓y` O' r Permit Fee y= I
LTotal Totat Fee ea 3Z