51105 STRELOT NO.
NO.® ¢ @LI1 FOR PLUMBING PERMITS
It OF CUPERTINO
W rc Sanitary No.
0 0' Date` MAR 2 9 1965 6— Permit
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3 LL Pee $�`/�
O R��RTANO
A�Ia o�hc City of Cupertino for a permit to install plumbing
o 1- pipes and�or fixtures listed on the reverse side hereof, and agrees to install said prices
a 1- and/or fixtures in accordance with the provisions of the Plumbing Code of the City of
<w Cupertino, and all other laws applicable thereto.
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U„\State Licens Approved
1� PLUMBING INSPECPOR
FIXTURES UMBEL MAIN DRAIN
UNITS FEES UNITS FEES
Water Heate Size
Ware, Closets Material
Bath Tubs To Curb
Showers To Prop. Lihe
Lavatories To Existing
Kitchen Sinks Not Conn.
Dish Washers Sewer Boxes
Waste Disposals '
'Clash—Trays STORM DRAINAGE
Washing Machines Size
Water Softeners Material
Bar Sinks To Main Drain
Comb. Sink s Trays To Curb
Dental Units
Drinking Fountains
MEMEL—
Floor Drains WATER.SYSTEM
Hoppers Size
Restaurant Sinks Material
Sand Traps TOTAL FEES
Urinals Fixture Fee'
rea Drains Main Drain Fee �P"a
mater Leaders - Storm Drain Fee
Jprinklcr ValvesWater Sys. Fee
Permit Fee
TOTAL TOTAL FEE
RECORD OF INSPECTION
_Underground Rough...
Partial Rough..
Rough. Complete..
Main Drain
Final...
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"'V LOT NO.
NO. STREET
APPLICATION FOR GAS PERMIT
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o i Date 1965 Permit No. /
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� Application is hereby made to the City of Cupertino For a 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 actor nce with the provisions of the Plumbing Code of the City
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aof Cupertino, and all o he I s ap cable thereto.
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Use of Premises
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PLUMBING INSPECTOR
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Remarks (Check ✓)
Type of Appliance Units Fees I 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 Size of Main
Gas Piping Fees ��S
Tested and Approved ....._................. ................._....__.........._._.....
DATE INSPECTOR