51187_I dA4 J 14//J,i LOT NO.L
,No./Fa''1
et
APPLICATION ,FOR PLUMBING PERMIT
CITY OF CUPERTINO
f o FIR 1968 Sanitary No
K LL March 29 168 S/ 7
9 196— Permit No
3a Date ., �i- �.sl •.._
W U n•. !_ .. .� Fee $
j LL
o Application is hereby made to the City of Cupertino for a permit to install plumbing
o w 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
< w Cupertino, and all other laws applicable thereto.
w x
0 LL Use of Premises
DHelli=
00
3 Owner D LZ_Crane Co. Address 2295 De La Cru,, Blvd.
oa
ZJ
By Palm Plumbing Co. Address 1234 N. Hire 9
O CONTRACTOR,AGENT
3
— o Phone 7. 115-9,3 3
.z
NEVICH
a 186579 WILLIAM D. Bc
O Y State License. Approved
a• o
- U� / PLUMBING INSPECTOR (/
FIXTURES
NUMBER
MAIN DRAIN
UNITS FEES
UNITS FEES
Water Heater
!
Size
Water Closet
Material i/
Bath Tub
/
To Curb
Shower
/
To Line
Lavatories
-Prop.
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 6'lain 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
Storm Drain Fee
Sprinkler Valve
Water Sys. Fee 6—,f
Relief Valve
Gas Fee
Vac Breaker
Skimmer
Filter
Permit Fee _17eAll
Total
57'
Total Fee 6-e
3 / 3 I ' — ' — eY� LOT NO.
NO. q/sSTTRE�` T -1p / / /
APPLICATION f fOR BUILDING PERM10
CITY OF CUPERTINO
MAR 29 1968',- . S
¢ Sanitary No.
Date t� 194 Permit No.07
d %�
Application isthereby`Inade ora pci it to
a — -;2— story, T e I Building
a. be occupied only as / in accordance with
Plans, Specifications and Plot -Plan filed hered . PI Ck Fee 'r4f a�
g � p
Estimated Value of Improvements, 4:2,�), — . Fee $ or)
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 complied with.
OwnefjS�J.1.Yi� Address a
By Address Address
Phoner;?yU----*')-��/D
ApprovedN ILLIAM D. BENEVICH
State License /4�7_/ 7?/ BUILDING INSPECTOR