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LOT NO.
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:APPLICT'IO.N FOR PLUMBING PERMIT
CITY OF CUPERTINO
0 2 J1( 1 `J Sanitary No.
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o Date 196Permit No
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LL w Application is hereby made to the City of Cupertino for a permit to install plumbing
o a pipes and/or fixtures listed on the reverse side hereof, and agrees to install said prices
a r and/or fixtures in accordance with the provisions of the Plumbing Code of the City of
a w Cupertino, and all other laws appli abl thereto.
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a o State Lrrer�e.. �T��� Approved
U PLUMBING INSPECTOR /
FIXTURES NUMBER
UNITS FEES UNITS FEES
Water Heatc Size
Water Closets Material
bath Tubs To Curb
Showers To Prop. Line
Lavatories To Existing
Kitchen Sinks Not Conn.
Dish Washers Sewer Boxes
Waste Disposals
Wash Trays STORM DRAINAGE
Washing Machines Size
Water Softeners Material
Bar Sinks To Main Drain
Com . Sink s Trays To Curb
Dental Units
Drinking Fountains
Floor Drains WATER SYSTEM
Hoppers Size
Restaurant Sinks Material
San Traps TOTAL FEES
Urinals Fixture Fee
Arca Drains Main Drain Fee
kVater Leaders Storm Drain Fee
5prinklrr Valves Water Sys. Fee
Permit Fee _
TO-TAL1 I TOTAL FEE
RECORD OF INSPECTION
Underground Rough
Partial Rough
Rough. Complete
\Iain Drain
Final
NO. STREET LOT NO
` CITY OF CUPER71NO 2.98
iL APPUCATTON FOR BUILDING MMIT, .
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SANITARY NO.
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FILE IJO. 5�.•(/J2 F
DATE 10/2/75 19 :(��'�'� • i^:
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i APPI'ientien it hereby mode for a permit•e ';• -f
n ddi+ion �_�a 2 story,ryq .5 .A•, :' � "!, —
to M«cvp:ed only as -
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' CONTR 1'r' Y ., ::. JL• j: 'AUDRES5
:PHONE ,3;'- SLATE LfCETb!!. �•'.•_+.
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_ ;•,.1.'r...:s ,.., `.,..' .:.:)'::'z„ ::`.�:'�:.611ROR16'N15PECTION RECORDa� _ =tS�—
FLOG MEE4
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_. _ PRE-GUN11E• FRAME:"'`.
.. 60ND BAMS - - LATH
"Yk 3`, ,•+. a -t+FA rZI” PAF
.. WALLBOARDS-W..'LtVT. .J"i'G�A' Pot
FBIFWAllS..':>i:^f^9'•4:. .;. '.;i tL2t`.. ' ROI
_ MEMBRANE I LANOSCAPING� ;b;:' t.f:S: •::^,i J1< •4,• MA
r.FIN
FINAL MDG.' -
- FIN
UNDERFLOOR f!vt't;4+1`
TIEDOWNS
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DIAPHRAMS
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ELECTRICAL INSPECTION RECORD
nLIDLMIIAI' oAfL MNlcma COM *CIAL D•rl nARUOA
UNDERGROUND ROUGH UNDERGROUND ROUGH . ..
ROUGH WIRING ROUGH WIRING
FINISH WIRING FINISH WIRING ' •'!�
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FIXTURES INTERIOR FIXTURES . ^Y
MOTORS EXTERIOR FIXTURES "
FINAL MOTORS
FINAL
. WSCELLANEOUS INSPECTIONS
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PLUMBING INSPECTION RECORD HEATING 6 INVECF04 4
..DAR .I MSrICtOR. ) 'i.3Vmir {+ - ;BATt:�: �!�•
FL IWJHMD F:, 10NOERFLOCRGAIMS-9 INSULATION
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UNDERGROUIN4 ROUGH FLUES&COMS.AIR..._.-.:
PARTIAL RO r CONDENSATE DRAINS
ROUGH COMPLETE FINAL APPLIANCE
ROOF DRAIN♦<LEADERS
MAIN DRAIN / b
FINAL GAS 6. 1
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CINAL PLUMBING - - `-
MISCELLANEOUS
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