51001.2 LOT NO.
NO. STREET
rr, APPLICATION FOR PLUMBING PERMIT
w
� a CITY OF CUPERTINO
TZ,w
r 0 Sanitary No.
0 a to 196— Permit loq 1, ca
w J U L 29 1968
' 0 Application is hereby ma e to the City of Cupertino for a permit to install plumbing
o ar i es and/or fixtures listed on the reverse side hereof, and agrees to install said rices
i Nl,I n�/ttu a with the rov�swns of the Plumbing Code of the Gty of
k' � IN p
a upertme;and"all'tithEP'I�z+7s applicable.thereto.____. .
w _
w Use of Premises Residence
00
> N
O a Ow er Address10497 Chare nr_
z B Address 243—B Moffett Blvd
161, 97 Chaos nr
F S°r Mt. iew, Calif.
— a Phone Q47—JA1.9;
w Z
o State License C36-165269 Approved
— PLUMBINGINSPECTOR
UNITS FEES UNn-sl FEES.
`Water Heart Size
Water Closets Material
Bath Tubs To Curb
Showers To Prop. Line
Lavatories To Existing
Kitchen Sinks Not Conn.
Dish Washe Sewer Boxes
Waste Dis
Wash Trays \ STORM DRAINAGE
Washing Machines Size
Water Softeners Material
iBar Sinks To Main Drain
'Com . Sink& rays To Curb
Dental Units
Drinking Fountains
floor Drains WATER.SYSTEM
HoppersSize
Restaurant Sinks Material
Sand raps TOTAL FEES
renals Fixture Fee
Area Drains ,/ Main Drain Fee
ater Leaders Storm Drain Fee
sprinkler Valves Water Sys. Fee
Permit Fee
TOTAL TOTAL FEE
RECORD OF INSPECTION
Underground Rough...
Partial Rough.. _
Rough. Complete..
:blain Drain
Final...
CITY OF CUPERTINO
10300 Torre Ave.
CORRECTION NOTICE
perfinent
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You are hereby no ied that no more work shall be
done until the above violations are corrected. When
corrections have been made call theApct�or.
jj'\252-4505 Date: -.. .. �e----------------
`Telephone Inspector: .. -
CITY OF CUPERTINO
00 Torre Ave.
CORRECTION ``
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