51001.23 S I 0/q ICTi 7M IVC OT NO. z/
NO. STREET
F?
PPL
mr OR BUILDING PERMIT
I
CU
PERTINO
APR ' //IQCO Sanitary Nu.—
Date I% r Permit No. .S—/ oG 4 1—
AdolliaVonGlferdBd tadtt'farra mmit to
story, Type
to be occupied only
Building
in accordance with
Plans, Specifications and Plot -Plan filed herewith. P1 Ck Fee
Estimated Value of Improvements, E of G O . 00 . Fee S
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 complie with.
Owner� / n Address -2 cdq &1VCq
By Gr/1 �L / Addressl C 12J
P :2 % �p.7 Approved ,
State License -2.2� - '�Q n BUILDING INSPECTOR V
"2 'l I 1,0/910-," &+T' V cyf. LOT NO.
NO. STREET
APPLICATION FOR PLUMBING PERMIT
z ` CITY OF CUPERTINO
j� E sod 4
x o l Sanitary No.
2 LL /
Uate f( U� 1961 Permit No SSU U L
3a
i LL Fee $ t7 O
LL W Appli aiio'nyls h-Wby dyp tt-trthq Cioy of Cupertino for a permit to install plumbing
o a pipes and/'i Gxtura h teRR:tli'd rcrv'erlc side hereof, and agrees to install said prices
i and/or fixtures in accordance with the provisions of the Plumbing Code of the City of
a w Cupertino, and all other Taws applicable thereto.
wx
LL Use of Premises
o_ o /// �/� �/J
3 Owner Address-,•-�.,
0
o a
Z J
zDy r
O 4 .-, -, -�� Address y"�"�/�e.iP.c.., a�i�. —✓��r,
CONTRACTOR, AGENT
3 Phone a�--293-do 77
w z
rca _ X3893 C
a o State Licence Approved
U PLUMBING INSPECTOR
UNITS I FEES
aste
Boxes
Vlllp 1
11 V f S
/ /4-0
Drinking Fountains
I
Am
Moor Drains
WATER SYSTEM
Hoppers
Size /
Restaurant Sinks
Material etr—
/�'m
San Traps
TOTAL FEES
Urinals
Fixture Fee
a 400
_
Area Drains
Main Drain Fee
0 o
Wi/�-ater Leaders
in Fee
�j^
Sprinkler V,Ivcs
Water Sys. Fee
f0
Permit Fee
�, 0 0
RECORD OF INSPECTION
Underground Rough
Partial Rough
Rough. Complete
Main Drain
Final .
V` J lhg--rn 11A; CIO 1- LOT NO.
NO. STREP.I'
" d
PPL-K;AVON FOR PLUMBING PERMIT
CITY OF CUPERTINO
_0 D
xo Sanitary \'o.
LL 1 1 ''L�
o � p; � PR 3' ,l�'f� 196 Permit No � Ede/. Z
3 a �}t
Pee $ % 6"
� o
P(t'kiyfatiq -9 %4? tiRTl�De City of Cupertino for a permit to install plumbing
0' pi Nd d/oft jf'ixtures fisted on t ie reverse side hereof, and agrees to' install said prices
a and/or fixtures in accordance with the provisions of the Plumbing Code of the City of
a w Cupertino, and all other (laws( applicable thereto.
4 Use of Premises Q
00 n/
� 3 Owner /" • Address -71
J z By Address /'-'
CONTRACTOR, AGENT ft
— < Phone -� — % ( 3
w z
0 State License � � — Approved
o /
U PLUMBING INSPECTOR (/
FIXTURES I NUMBER �� MAIN DRAIN
UNITS FEES FFES
To
Kitchen ink Not Conn.
Dish Washer Sewer Box
Waste Disposal ,.
Washina Machine I•'1I Size
Bar Sink To Main Drain I
Comb.Sink & Tray To Curb
Floor Drain I 1 11 WATER SYSTEM
ban d'I'rap
TOTAL FEES
Urinal
Fixture Fee
Area Drain
Main Drain Fee
Water Leader
Storm Drain Fee
Sprinkler Valve
I IlWaterSvs.Fee
Vac
Total 1 10, 0011 Total Fee �!� /)