51071I ee-p, l T- D L. LOT NO. `Jb
NO. STREET
C-APPL-ICATION�FOR PLUMBING PERMIT
CITY,OF CUP!,
WsEP 2,51967 sanitary No.
Date 9 — Z 5,— , 19677
CITY OF CUPERTINO
Application is hereby made to the City of Cupertii
pipes and/or fixtures listed on the reverse side here
and/or fixtures in accordance with the provisions of
Cupertino, and all other laws applicable thereto.
Use of Premises
Owner -:.j
G Ce
By At l � �r 4 �—
CONTRACTOR, AGMT
Phone 2-,W7rfJ
State License L! l7 t -1 C
Permit No SSU 7/
Fee $ if "
m for a permit to install plumbing
If, and agrees to install said prices
the Plumbing Code of the City of
mh
Address %S`VuAl2-e-1 r -t ST—
Approve
PLUMBING INSPECTOR V
FIXTURES
NUMBER
MAIN DRAIN
UNITS1 FEES
11 UNITS FEES
Water Heater
11 Size
Water Closet
Material
Bath Tub
To Curb
Shower
To Prop. Line
Lavatories
'Po Existing
Kitchen Sink
Not Conn.
Dish Washer
Sewer Box
Waste Disposal
Wash Tra
STORM DRAINAGE
Washing Machine
Size
Water Softener61atcrial
Bar Sink
To Main Drain
Comb.Sink & Tray
To Curb
Dental Unit
Drinking Fountain
Floor Drain
WATER SYSTEM
Hopper
Si ze
Restaurant Sink
I Material
Sand Trap
TOTAL FEES
Urinal
Fixture Fee
Area Drain
Main Drain Fee
Water Leader
Storm Drain Fee
Sprinkler Valve
Water Sys. Fee .i"°
Relief Valve
/zC'
Gas Fee ,r
Vac Breaker
Skimmer
Filter
/ f
Permit Fee a
Total
�/ °f'
Total Fee Ov
LOT NO.
NO. STREET
C FOR PLUMBING PERMIT
z < ® �C� CI P CUPERTINO
x p �Ti 2�i_4961 Sanitary No.
LL
p < Date Permit No
3
u /� T�/ ''n�pT A� s
LL w pA D OF eQURER �NG t7 P Pee plumbing
� ° A t� n er I of-Cupertino for permit to install lumbin
p a 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
a w Cupertino, and all othe�IaI appliicc,a]4e thereto.. /
LL Use of PremisesL d.eL
�00 �J L
3 Owner_ Gr_ �7 -e`' Address -wd
� a By�D �� u in Address, y
CON TRACTOR,AGENT
3 <
a 1-77
Phone I
— z
w z
a o State License,/�'f cJ 0 6 Approved
u PLUMBING INSPECTOR (�
FIXTURES
41 UNITS FEES UNITS FEES
`.Crater 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
Com . Sink-&Trays To Curb
Dental Units
Drinking Fountains
Moor Drains WATER SYSTEM
HoppersSize
Restaurant Sinks Material S
San Traps TOTAL FEES
Urinals Fixture Fee"
Area Drains Main Drain Fee
ater Leaders Storm Drain Fee
Sprinkler Valves Water Sys. Fee /if"O
Permit Fee ,Z o
TOTAL TOTAL FEE rp
RECORD OF INSPECTION
Underground Rough...
Partial Rough..
Rough. Complete..
Main Drain
Final...
/yo I � // .? A . L°T NO. 3P
NO. STREET
z ; APPLICATIOWFOR BUILDING PERMIT
r°
Q 0 1 CITY OF CUPERTINO
o f U U '/6 IyOr Sanitary No.
ILL -'Date �6 196 -;/'Permit No, S-/ D 7/.
0°wpermit to
u 1 �,cat�pfis W •��i ��
o�
i to a 1 P story, Type _ ��
�h l Building
<w
to be occupied only as `+ rr t in act dance with
00 Plans, Specifications and Plot -Plan fil d herewith. PI Ck Fee 7 JL -w
> m IO
Estimated Value of Improvements, $ y ��� Fee $ �S
o<
z J It is hereby agreed that the requirements of the Cupertino Building and Zoning Ordinances and
J z all other laws applicable to the construction, location, and use of buildings within the City of
J o Cupertino �wwiyyll be co/m'pliedpwith. /
3 4 Owner C%�DuC/ /,I/r IA/ Address moo/ 4p il�f_F�...,/'�( ,��.
Wz
WW By if/o.r{�tlP Lo Sf /i� Address
u s 9r✓ .lar -
oPhone , lIK— O a Z
_ u p Approved WILLIAM D. BENEVICH
State License �_ / - �Qr�%O� BUILDING INSPECTOR /