51001.3Lor
NO. Sn EET
F AAPP�IC TION
nY tITY
It -
(DEC ? fi 1963a
Dated a i. s 19 8 , 196—
FOR PLUMBING PERMIT
OF CUPERTINO
Sanitary No.
Permit No —�y d 3
'7\/(?r 11Ilt?f_❑T❑Wq Fee$ 3. S-0
^
OA'pplication isiherebyfmadevo 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 10480 Ainsworth
Owner Flave Jones Address Cupertino
Baynw Wa+er Con iit.ionin[
CONTRACTOR,AGENT
Phone967—Ik51,5
\State Licens4-1 `52ri�
:Address 243—B Moffett Blri.
Y
Approved
PLUMBING INSPECTOR
ns
UNITS
Fee
RECORD OF INSPECTION
N i
w
/o
NO. STREET
LOT NO.// 9 /
'7a-/
L AT ON FOR PLUMBING PERMIT
TY OF CUPERTINO
GGG������--- p Sanitary I
Te
Dat /SEP %/ 1960 Permit No
;s
IgO
Fee $a6 - JV
�AjSjitatjgr[is hfbAlrlkd8hl�e City of Cupertino for a permit to install plumbing
pipe's a d/ r fixt i 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.WILLIP.,A D.
Use of Premises
Ow e l7•Address��fi�-+�
Addresl2�
PhoneCONT/Fj/AGpTO R, AGENT
a- o
State License 3 ,r
Approved
1 PLUMBING INSPECTOR v
FIXTURES NUMBER MAIN DRAIN
UNITS I FEES UNIT'S FEES
Water Closet I 2 1 11 Materia[(.%_ /.
Kitchen
To Pron. Line
Sewer Box
Size
Comb.Sink & Tray
To Curb
Dental Unit
Drinking Fountain
Floor Drain
WATER SYSTEM
Hopper
Size
Restaurant Sink
Materi
Sand Trap
TAL FEES
Urinal
Fixture Fee
Area Drain
Main Drain Fee .00
Water Leader
Storm Drain Fee
Sprinkler Valve
Water Sys. Fee /
Relief Valve
Gas Fee
Vac Breaker
Skimmer
Filter
Permit Fee
Total
Total Fee