LOT 50/D/ 3 % 1 M. TO ftAl. .V/yE LOT Nn -166A
NO. STRF.P.T
APPLICATION FOR PLUMBING PERMIT
z 2 Q CITY OF CUPERTINO
ro Sanitary No.
Q 4
0 Date 1962 Permit No
a
3 LL Fee 3 cR',
�o
Application is hereby made to th 'ty o rti a ermit to install plumbing
o 1- pipes and/or fixtures hsted'on tt v nd s to install said prices
> < and/or fixtures in accordance wit�l provisions o I ag Code of the City of
a w Cupertino, and all other laws app c r t
w ��� g� 1968 ti
Use of Premises£ f
0 0 /t .� /�C �"
3 Owner_C-• I—_ 'TV �%f GAUR sfdi(I,_ &V -6S,
SuGE
o a C�
J z By [�,ellEleA� �y.0/U/LCe�ye/LC.
0 CONTRACTOR,AGENT 625 Charles Street
3 r
— M Phonewi San Jose, California 95112
wz
z a 15,x.2_
u s State License ApprovedX
rI, a U PLUMBING INSPECTOR ✓
l
(y&FIX'TURES I NUMBER �� MAIN DRAIN
UNITS FEES UNITS FEFS
Water
Lavatories 11 To Existing
Kitchen ink /.19-0 Not Conn.
Dish Washer Sewer Box
Waste Disposal
Material
Comb.Sink &
IIL'1i11el
Hopper
Si ie " I
Restaurant Sink
_
Material4l-1/
Sand Trap
TOTAL FEES
Urinal
Fixture Fee
Area Drain
Main Drain Fee
126
Water Leader
Storm Drain Fee
Sprinkler Valve
Water Sys. Fee
S
Relief Valve
Gas Fee I
e-23
Filter
Permit Fee
Total /Q /.5.Do Total