51075.8 ', No. Street ' Lot Wo: '
o
CIO
To10 APPLICATION FOR PLUMBING PERMIT
8 CITY OF CUPERTINO
AUG 18 1911
U
q Sanitary No. r
fVte Q 196_ PemtitNoa7/D'S�
3 Fee
Application is hereby made to 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. 4*fr-
Use of Premises
Owne Address
d
y By
Addes-
ContractWAgent �—
Phone
State License` Approved agar
L ®� iy_ Plumbing Inspector
FIXTURES NUMBER MAIN DRAIN
Units Fees Units Fees,
Water Heater Size
Water Closet Material
Bath Tub To Curb
Shower To Pro .Line
Lavatories T Ex'
Kitchen Conn.
Dish Washer
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 System Water Sys.Fee
Relief Valve H Gaq Fee
Vac Breaker
Skimmer
Filter
Permit Fee
Total Total Fee
` 101100 Tantau Avenue LOT No.
NO. MEET
APPLICATION FOR GAS PERMIT
a i CITY OF CUPERTINO
x
' 0
3.c Date AuMust 1 19671 Permit No. ��0 7S d'
= o Fee•$ ��
Application is hereby made to the City of Cupertino fora permit to install gas pipes
o and/or gas appliances as listed on the reverse side hereof, and agrees to install said pipes
a and/or appliances in accordance with the provisions of the Plumbing Code of the City
i O of Cupertino, and all other laws applicable thereto.
ux
Sr Use of Premises Industrial
00
of Owner FOUR—PHASE SYSTEMS Addressld 00 Tantau Avenue
Zgy ADVANCE ENGINEERING CO. Address10218 Imperial Avenue
° CONTRAcrOR,AGENTCu ertino
m Phone 253-4050 p
W
ao State License188596 Approved
-0 PLUMBING INSPECTOR
IP•
t
c' Remarks (Check J)
Type of Appliance Units Fees New Replace Relocate
Gas Ranges
Wall Heaters
Gas Plates
Circulating Heaters
Blower Furnaces
Gas Fired Boilers
Warming Ovens
Percolators
Griddles
Steam Tables
Gravity Furnaces
Suspended Unit
Floor Furnace
Miscellaneous
(NAME TYPE)
HOUSE GAS PIPING
Number of Outlets I & I Size of Main
Gas Piping Fees
TAtedand Approved ........................I.................................. _..........
DATE INSPECTOR
a