51001.3 2 (, 3 u Q-7 COY NO.
NO. STREET
N APPo T FOR PLUMBING PERMIT
W i ® C Y CUPERTINO
' W Sanitary No.
LL
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o f DatePermi J-1 C, a /3
3 U t No.
i LL Fee $ 3, —d
° A lica h
pp f Cupertino for n permit to install�y q Y r�3y �Q {$ t I lumbin
t��! Mt �d4id M�` Ue P P plumbing
o a pipes and I tur hg,
a side hereof, and agrees to install said prices
i N and/or fixtures in accordance with the provisions of the Plumbing Code of the City of
aw Cupertino, and all other laws applicable thereto.
W x
j LL Use of Premises
aoOwne n
ddress
_CdI
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.�e
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o a
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CONTRACTOR, A13%eZ Phonen?
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W W 1
¢ a xx
a o State License `L Approved
PLUMBING INSPECTOR ry /
y
FIXTURES NU,), BER
UNITS FEES UNITS FEES
Water Heate 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
Comb. Sink a Trays To Curb
Dental Units
Drinking Fountains
Floor Drains WATER SYSTEM
Hoppers Size
Restaurant Sinks Material
San Traps TOTAL FEES
Urinals Fixture Fee
Area Drains Main Drain Fee
'Water Leaders Storm Drain Fee
Sprinkler ValvesWater Sys. Fee 100
Permit Fee
TOTAL TOTAL FEE )
RECORD OF INSPECTION
Underground Rough.,.
Partial Rough..
Rough. Complete-
.Main
omplete...Main Drain
Final...
2?,320 ,E�.u,c7L/
c No. Street Lot No.
o —
APPLICATION GORgJ..0 GPERMIT
_v Sani �No.
c
x Date ,F9(6S EP 2 3 1968 Permit No. e'f
° Fee
3 MTV . �r Cr"t" Irll�
Application is hereby made tojthe,Ctty�o(Cdpegjm RTa ape it to install plumbing pipes
and/or fixtures listed on the reverse side hereof,and agrees to install said prices and/or fixtures
o in accordance with the provisions of the Plumbing Code of the City of Cupertino,and all other
"c laws applicable thereto.
ro Use of Premises iP/dam 7-4�1= �n
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° Owner Address f�rl�s�.!/ Address'2—Z2o' JC//i./J(Ci
0
_ // .7n-' Z
BY �i��.e�C$T eC/ _ Address
3 s Contractor,Agent
d ° Phone
— State License /..S�.� �J Approved
madam,Inspector
FIXTURES NUMBER MAIN DRAIN
Units Fees Units Fees
Water Heater Size
Water Closet Material
Bath Tub To Curb
Shower To Prot). Line
Lavatories To Existing
Kitchen in Not Conn.
Dish Washer
Waste Disposal
Wash Tray STORM DRAINAGE
Washing Machine Size
Water Softener Material
Bar Sink To Main Drain
Comb.Sink&Tray To Curb
Dental Unit
Drinking Fountain
Floor Drain WATER SYSTEM
Hopper Size
Restaurant Sink Material
Sand Trap TOTAL FEES
Urinal I Fixture Fee 7 45
Area Drain Main Drain Fee
Water Leader Storm Drain Fee
Sprinkler System Water Sys.Fee
Relief Valve Gas Fee Tv
Vac Breaker
Skimmer
Filter
Permit Fee O
Total Total Fee
0.3 c;zj xl"'mow XZ4 LOT NO.
NO. STREET
APPLICATION FOR PLUMBING PERMIT
�\ 1
ITY OF CUPERTINO
so .,l '� Sanitary No.
Y
LL
O < Uate (SEP Q Iq !� 1962 Permit No
O
3 V Fee S
j LL
LL w Applicationlishereby��rrl�Ide}tq?thetCity of Cupertino for a permit to install plumbing
o r- pipes and%ortfixturcgili�ed,Ren tlie4everse side hereof, and agrees to Install said prices
and/or fixtures in accordance with the provisions of the Plumbing Code of the City of
In
Cupertino, and all other laws applicable thereto.
w x
� r
Use of Premises
J LL ��.
00
r3 OwnerAddressr'✓l- >'-'
oa
zJ
o By . Address K�' e—
CONTRACTOR, AGENT
Phone 5Z 7 7
w z
rc a o� pc� Approved
a o State License �r '•''
T ✓
PLUMBING INSPECTOR
FIXTURES NUMBER MAIN DRAIN
UNITS FEES UNITS FEES
Water Ileater I Size
Water Closet S Material
Bath Tub / To Curb
Shower To Prop. Line
Lavatories A 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 Main 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 rp0
Water Leader Storm Drain Fee
Sprinkler Valve Water Sys.Fee f JV
Relief Valve Gas Fee
Vac Breaker
Skimmer
Filter
It Permit Fee ZP,0-
Total 11,JbIl Total