51187LOT NO.
Q NO. STREET
W p SAP-P,LICATION�; F,OR BUILDING PERMIT L
r o CITY�OP CUPF.RTINO
° < ?MAR 2. 1968 U� Sanitary No. SS�f3 $G
i W Date _ 19th Permit No. r�// 7
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a story, Type S— Building
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ied only as in accordance with
to be occup
20 Plans, Specifications and Plot Plan filed herewith. PI Ck Fee —
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Estimated Value of Improvements, $2��..._400- - Fez $
z J It is hereby agreed that the requirements of the Cupertino Building and Zoning Ordinances and
J Z all other laws applicable to the construction, location, and use of buildings within the City of
d o Cupertino 'll be complic with.
3 a
_ N Owner Address !/e
a a By Address— &Z�J
40 Phone
_ O Approvedrtt I ; ^ pq
�} State License,/.L /.79 / BUILDING INSPECTOR„ ^ /
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LOT NO. 4f
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i APPLICATION FOR PLUMBING PERMIT
IAPR A Ic68CITY OF CUPERTINO _
J Sanitary No.
/���h,�9�1968 r// 7
Date — 196— Permit No y
D Pee 3 a3 SZ
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 Dwelling
Owner Di tz. .Crane Co
Palm Plumbing Co.
By CONTRACTOR, AGENT
Phone 245-2323
State License 186579
Address 2295 TIP T.a r,",, Alma
Address 1234 N. Hxy 9
WILLIAM D. 13ENEVICI-4
PLUMBING INSPECTOR
FIXTURES
NUMBER
MAIN DRAIN
UNITS FEES
UNITS FEES
Water Heater
Size
Water Closet/
Materia]
Bath Tub
To Curb
Shower
To Pro . Line
Lavatories
,2
To Existing
Kitchen Sink
/
Not Conn.
Dish Washer
Sewer Box
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
r fixture Pee
Main Drain Fee
Storm Drain Fee
Fee
Filter
Permit Fee � N�
Total V�jJ� Total Fee y,.