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"C. we -9 I D-,7- ll/ /I A' a Lel -0— LOT NO.
NO. STREET 0
APPLICATION FOR PLUMBING PERMIT
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r o J anita % inn.
3� Date �.9� 7 1968 Pe jNe -1—// 13 /
i LLFee S. 3- V
o Application is hereby made to the i o��� (
f P } H t, u'yeb� �ty 1permit to install plumbing
o a pipes and/or fixtures Irsted n��,.h re�;•rsc . i Hereof hnd,ngrees to install said prices
I and/or fixtures in accordance Hath the provisions of the Plumbing Code of the City of
a w Cupertino, and all o0rcr,\1aws applicable,t
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Use of
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State Lied ��3d
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Address / / J
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U� PLUMBING INSPECTOR
FEES
Water Hcatc
Sprinkler VJ,cs Water Sys. Fee =i
RECORD OF INSPECTION
Underground Rough
Partial Rough
Rough, Complete
\lain Drain /
Final-�'—
ak31 De An7.a Circle N. LOT NO. 3
NO. STREE.I'
�_.APPLICAT10% FOR PLUMBING PERMIT
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'0 ,J� ] 7 Sanitary i\u.
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o Date �TU�y� 70 ��6% I � Permit No IS //0 7. /
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n`� Pec 5--2- 50
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4 APPI'c�rriaflf�L•lfy f Cupertino for a permit to install plumbing
O a pipes and/or fixtures listed on ie res1XV side hereof, and agrees to install said prices
r and/or fixtures in accordance with the provisions of the Plumbing Code of the City of
a w Cupertino, and all other Taws applicable thereto.
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a Use of Premises RPgi_ti ant. 1 al
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3: Owner W,.I, Griffiths Address De Anza Circle
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o By Hillview Plumbing On Address 2269 Mora Dry 1d_V
3 F CONTRACTOR, AGCNT
0 Phone 948-71.54
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aa //`ice
a o State License 16713.5 Approved
U i I - PLUMBING INSPECTOR
Water Hcara - I i I /.IZ II Size I I
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Kestaurant Sinks
Material o
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San raps
TOTAL FEES
Urinals
Fixture Fee
Area rainsPain
Drain Fee
/ater Leaders
ain Fee
Sprinkler Valves
Water Sys. Fee
Permit Fee
TOTAL
j 3 ,So TOTAL FEE
RECORD OF INSPECTION O
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