1711 LOT NO.
• NO.: STREET
J� P TION FOR PLUMBING PERMIT
CITY OF CUPERTINO
4 ' AUG 10 1962Qy—���, 7
Date V , 19,C—?— Permit No.
ITY 0:= CUPERTINO 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. •"
' .
Use of Premises_.
:a j
41 Owner Address
By Addres
COiTMCTOR, AGENS:.•
Phone Approve
PLUMBING INSPE R
l�
FIXTURES NUMBER MAIN DRAIN
UNITS FEES JUNITS1 FEES
Water"Heater * 1 Size
Water Closets QMaterial rZ
Bath Tubs / To Curb
Showers To Prop. Lin
Lavatories �_ �� To Existing
Kitchen Sinks Not onn. , –•a
Dish Washers 1 SEWER BOXES
Waste Disposals
Wash Trays STORM DRAINAGE
Washing Machines 11 Size
Water Softeners Material I 1 ;';t 1 .
Bar Sinks 1 1� To Main Drain .: ,
Comb. Sink a Trays 1 t To Curb 1_ 1
Deal Units 1 I
Drinking Fountains �AW
Floor Drains WATER SYSTEM
Hoppers 1 1 1 Size -(—�
Restaurant Sinks Material 1
Sand Traps 1 1 1 TOTAL FEES
Urinals 1 11 Fixture Fee - 1/2
Area Drains 1 Main Drain Fee I ( 6i
Water Leaders 11 Storm Drain Fee
SpnnkiV.wes 1 1 11 Water Sys. Fee 1 ( oto?
1 1 1 Permit Fee e.-cJ
TOTAL 1 1 TOTAL FEE ( d
OR OF CTION
Part' Rough
Roug Comp ete G i
Final Z
V'
Bldg. Dept.
Office Copy
BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTINO
C] Sewer Connection Sanitary Permit No. -------
� Plumbing Final - Plumbing Permit No. -11711..........
t
Owner..or Tenant ...... - - -- ---- --- ---
At 114,97
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Tract ................. . .... .....
-- ------ --- - - - - - -------......
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Date Connected ........ - -------.....----9.:.agr
................................ ............................ 19---
Date Final --------------------------------
----------------------------------------------- 19-as,
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LUMBING INSPECTOR
1A/61-5oo