1865 Id
LOT NO.
No® R PLUMBING PERMIT
!NOV 20 1962c1 � ; ccrnExTTNo
Q� Date -q , 194 ., Permit No.
CITY OF CUPERTINO Pee $ c�
1 Application is hereby made to the City of Cupertino for a permit to install plumbing
I 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.
b' Use of Premises) w� 1•, J--2^^'-"�� -
'a
owner R L - Vy A% ddress
Address
ayirl 5 0
Phod040 Longfellow Avenue Approved
Campbell, California PLnAfSING INSPE on
1 UR. NUMBER
UNITS I FEES .II IuNITsi FEES
Water Heater j 11 Size • '
Nater C osets j Matetial i
Bath Tubs 11 To Curb j
Showers To Prop. Line
Lavatories I j1 To Existing
Kitchen Sinks I I II Not Conn.
Dish Washers _ I I Ij SEWER EloxE9 I
Waste Disposals-`,j•
W— Trays �� STORM DRAINAGE '
Washing., ac Ines j 11 Size I j
r 193[a*R°Seffeners I I II Material I j .
Bar Sipks 'vim.:.• �� To Main Drain I
Comb. Sink&Traysl To 'Curb I '
Dental Units I II '
Drinking Fountains) I II
Floor Drains I 11 WATER SYSTEM
Hoppers . j I l Size •
Restaurant'Sinks 11 Material j
Sand raps TOTAL FEES
Urinals I 11 Fixture Fee I
Area Drains j1 Main Drain Fee
Water Leaders I 11 Storm Drain Fee
Sprinkler Valves I I 11 Water Sys.'Fee
I II Pbrmit Fee
_TOTAL I TOTAL FEE
RECORD OF INSPECTION
Partial Rough
Rough Complete
Fina— l