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51196�e'r I dL 'y C/ �/1 J,' LOT NO. G 1 NO. STREET ` A' PPLICATIO'N�FOR BUILDING PERMIT Z– r s 0 1' L-`--' �) 1 xl t ;< ° CI OF CUPF.RTINO s� 0:5 hA AR 2 R 1968 U Sanitary No. i `Date — 196 Permit No. iw 6 o 0 App�i�atio'n�liIss her by[m`d; fdr+jG rmit to 1ZECT o< iV) a /*iyz story, Type G Building to be occupied only as '_5'/n,t:2[E in accordance with o`o Plans, Specifications and Plot-Plan filed herewith. Pl Ck Fee 14 Estimated Value of Improvements, E ° a mo Fees S4 iJ It is hereby agreed that the requirements of the Cupertino Building and Zoning Ordinances and * Z all other laws applicable to the construction, location• and use of buildings within the City of J 0 Cupertino will be mmph with. 3 N Owner X lY• �(/- 19Rtrzrs Address �. W a By 7FT1lJVf! TA$'�LL�7 Address x t ` 0 Phone /. Approved ' State License �BUILDING INSPECTOR / LOT NO. NO. _ STREET etAPR CARPLICA`TIOMFOR PLUMBING PERMIT I GiITY'OF CUPERTINO E1 ISM sanitary No. 0 0 Date " 19ffT'//6 Permit No a i LL Pee $ - r \'+•1't'l-.t t .. l O Application is hereby made to the City of Cupertino for a permit to install plumbing `o 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 o er laws applicable thereto. wx u. Use of Premises O 00 3 Owner—::&7--" Address ,By Address O CONTRACTOR, AGENT a Phone —w w z a ° < d S % `/ � ApprovedWILL1AM D. DENEVICH _ o State License a / U PLUMBING INSPECTOR V FIXTURES NUMBER MAIN DRAIN UNITS FEES UNITS FEES Water Heater I Size 41' Water Closet Material 6.1 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 blain Drain Comb.Sink & Tray To Curb Dental Unit Drinking Fountain Floor Drain WATER SYSTEM Hopper Size `I Restaurant Sink Material Sand Trap TOTAL FEES Urinal Fixture Fee Area Drain blain Drain Fee S----rj Water Leader Storm Drain Fee Sprinkler Valve Water Sys. Fee .fz Relief Valve I Gas Fee S"a Vac Breaker Skimmer Filter Permit Fee Total VIbtal Fee a