511341�_f 9 1 � 0 / CAeEe �- /AY. LOT NO.
NO. STREET
°.ASP-L-'C_e, ATIONu- FQ.R BUILDING PERMIT
`raWs Cry PERTINO
Sanitary No.
AY 3 1 1968 ;
Date �� 196= Permit No. //�S SC
ApplicPtibn ds h003y n1109, 7E permit to /62
a story, Type Building
to be occupied only as in accordance with
Plans, Specifications and Plot -Plan filed herewith. P1 Ck Fee
Estimated Value of Improvements, $ Z Fee $ /ZOO
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. r�
Owne z_ 04exs // '511), 9 Address_�f �� � / "f/ ��At/•
Byl(./�e�'®.Si' /`' G,� Address r_5�� ,k' 4! Via:, ,. 't''�/�✓�
Phon'. 1241 _ /260 Approved' 1-1-YA',ai_,,'1=1ZAIE,,."feff
-..l
State License 6 ,7r2, f-' BUILDING INSPECTOR /
M-4 0 I ReAof MEE LOT NO.
NO. STREEI'
APPLICA1TJ," FOR PLUMBING PERMIT
[TY ERTINO
w � 1�
� i
10 mitary No.
a
Permit No Date S e2 � 'MAY
� v��,�-�,�
w U Fee $ 9 s�
2 LL
O Application isr'lereNy m3dt' trth tt of Cupertino for a permit to install plumbing
`o a pipes and/or fixtures�listc�d'on the ieLfr �4d�hereof, and agrees to install said prices
> and/or fixtures in accordance with the provisi0 sof ,the Plumbing Code of the City of
a w Cupertino, and all other laws applicable thereto.
Use of Premises TD /A/S 7, L sSW//'9 Pnot_
0 0
oa Owner LoU/$ TT. S/L��D/�$ Address/9946 FFLidl
By J4/✓/r'/S7' PDaGS Address&,69 4c- PLL2411IAld
O CONTRACTOR, AGENT
3 `m
Phone—� •1360
wz
WILLIAM D. BENEVICH
u f State Lice,,n2049 a� 0 Approved
ry
PLUMBING INSPECTOR
FIXTURES NUMBER MAIN DRAIN
UNITS FEES UNITS FEES
Water Heater Size
Water Closet Material
Bath Tub 'I'o Curb
Shower To Prop. Line
Lavatories 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 SYS'T'EM
Hopper Size
Restaurant Sink Material
Sand Trap TOTAL FEES
Urinal Fixture Fee Q O
Area Drain Main Drain Fee
Water Leader I Storm Drain Fee
Sprinkler Valve Water S s.Fee
Relief Valve / Gas Fee
Vac Breaker /
Skimmer /
Filter /
Permit Fee
Total Total Fee 6�