51118 / �[
Syr✓ �L/ Lf G� LOT NO.
NO. STaEET '
b ¢ ® (AP.PLI'C�AToON FOR BUILDING PERMIT
r ° C. IITY�I Or CUPERTINO
R LL ,
o < Sanitary No.
'r. 7 �r 7
= u Date �/ - 19 196.,L Permit No. s///
O
4W Applicati n is here made for a permit to e�
<m a � story, cbuilding
<
to be occupied only as
o 'o in accordance with Plans, Specifications and Plot- an filed herewith.
Estimated Value of Improvements,e5-tr�. Fee
iJ It is hereby agreed that the requirements of the Cupertino Building and Zoning Ordinances and
.a Z all other laws applicable to the construction, Iocatiup, and use of buildings within the City of
o Cupertinowdl by compl� with.
3 „ Owner + :: Address�v%"00 04!6-._� . C
a s By x TFgff,,- ' Address Arffl Y U 7a
Ox
e7 L J' 7
<U Phone Approved -
+ State Licensed �� 3 3 yJ _ NG INSPF.CTOa
tl L/
RECORD OF INSPECTION APPROVALS
FOUNDATION
DATE. INSPECTOR
UNDERFLOOR j
DATE INSPECTOR
FRAME
DATE INSPECTOR
LATH and PLASTER
DATE INSPECTOR
FINAL BLDG. j
DATE INSPECTOR
FINAL ELEC.
DATE INSPECTOR
FINAL PLBG.
DATE INSPECTOR
FINAL GAS
DATE INSPECTOR
FIXTURES
NUMBER
MAIN DRAIN
UNITS
FEES
UNITS
FEES
Water Heater
Size
Water Closet
Material
Bath Tub
To Curb
Shower
To Prop. Line
Lavatories
To Existing
Kitchen ink
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
Water Leader
Storm Drain Fee
Sprinkler Valve
Water Sys. Fee
Relief Valve
Gas Fee
/ 5�
Vac Breaker
5�
Skimmer
S Z
Filter
Permit Fee
Total
Total Fee
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LOT NO.
NO. STREET
`PLICATION
,ITY
FOR PLUMBING PERMIT
OF CUPERTINO
Sanitary No
Date t y �/ 196—,'7 Permit No
Fee $ S
Applitition i� �hor�6. ima,cie, �o the City of Cupertino for a permit to install plumbing
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
Cupertino, and all other laws applicable thereto. t
Use of Premises
Owner ``�'f/ Address ZC ova
By / Cam'/ ��7. L� Address��� "�! �—
C NTRACTOR, AGENT
Phone
State License.
0—
Approved
PLUMBING INSPECTOR Y
FIXTURES
NUMBERv,
MAIN DRAIN
Units
Fees
Units
Fees
Water Heater
Size
Water Closet
1
So
Material
Bath Tub
1.50
To Curb
Shower
50
To Prot). Line
Lavatories
1. t0
To Existino
Kitchen
Conn.
Dish Washer
Waste Disposal
Wash Tray
STORM DRAINAGE
Wa Machine
Size
Water Softener
Material
Bar Sink
To Main Drain
Comb.Sink & Tray
To Curb
Dental Unit
Drinking Fountain
Floor Drain
WATER SYSTEM
hC"AT/oN
Hopper
Size
Restaurant Sink
Material
/." 0
Sand Trap
TOTAL FEES
Urinal
Fixture Fee
.00
Area Drain
I Main Drain Fee
�-
Water Leader
Stom DrainFee
�—
Sprinkler System
Water Sys. Fee
.SO
Refief Valve
Gas Fee
-&—
Vac Breaker
Skimmer
Filter
Permit Fee
2.0
Total
Total Fee
Q. 570
-No. Street Lot No.
a / ICATIGN FOR PLUMBING PERMIT `
_ 'CITY OF CUPERTINO
0
U Sanitary' No.
�. t;r� / 196_ Permit.No.'SI%�O
a -:. g'• ' �`` Fee. $ •9 50
ApplicaYon((� ereby made to the City of Cupertino for a permit to install plumbing pipes
w and/o�tuiC�s listed on the reverse side hereof, and agrees to install said prices -and/or: fixtures
° in a�� ance with the provisions of the Plumbing Code; of the City of Cupertino, and• all other'
'M lawspplicable thereto.
4° Q
e co Use of Premises
p U
° Owner Address
cc
.^ cc By Address
°' Contractor, Agent
0
a Phone 3 7 r� 7 2. - �
Cd 3
State License 7 `� / _ Approved V AAV
Plumbing Inspector (�