2065 �!C 1 L.�1- LOT N6.
NO. STPEEI
APPLICATION, FOR PLUMBING PERMIT
z s i/ 'CITY OF CUPERTINO
MAY 15 1963 �-��� Sanitary No.
o J Date , 196— Permit No l0
a
I0 CITY OF CUPFRT'V" Fee $ 7i
o Applica ion 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
> 1- and/or fixtures in accordance with the provisions of the Plumbin Code of the City of
WCupertino, and all other s applicable thereto.
w x �
� r
n Use of Premises
00
0 3 Owne Address
iJ
, By Addres
3 0 y �O TRA TOR AGENT
ne
- z l-r
w
2
te License Z6 7Z z�7Z Z/ Approved
ra
PLUMBING INSPECTOR
HX I URESSNUMBER MAIN R I
UNITS FEES UNITSI FEES
Water Heater Size
Water Closets Material
Bath Tubs To Curb
Showers To Prop. Line
Lavatories , and To Existing
Kitchen Sinks Not Conn.
Dish Washers Sewer Boxes
Waste Disposals
Wash Trays STORM DRAINAGE
\Gashing Machines Size
Water Softeners Material
Bar Sinks To Main Drain
Comb. Sink m Trays To Curb
Dental Units
Drinking Fountains i
Floor Drains a.p WATER SYSTEM\
Hoppers Size
Restaurant Sinks Material
San�Traps TOTAL FEES
Urinals. Fixture Fee
Is—
Area Drains Main Drain Fee
Water Leaders Storm Drain Fee
Sprinkler Valves Water Sys. Fee
Permit Fee 'at.
TOTAL TOTAL FEE
RE2NV OF INSPE ION
Underground Rou_
.Partial Rough..
�Roug,h. Complete..
\lain Drain
Final...