NO PERMIT NUMBER/0/7;z 1-00-1 t L— '-C L r - LOT NO. �
'N,1 �'Z�'STREET I\
APPLICATION FOR PLUMBING PERMIT
zz 15 AUG 12 1968 CITY OF CUPERTINO
zo r Sanitary No.
o Date^ - • • 6-- - 1961 Permit No
3 4 I Pee $ a9. O
10
Application is hereby made to the City of Cupertino for a permit to install plumbing
opipes and/or fixtures listed on the reverse side hereof, and agrees to install said prices
r and/ fixtures in accordance with the provisions of the Plumbing Code of the City of
a w Cupertino, and all other (laws applicable thereto.
Use of Premises Q+S
00
7 N e�+
0 3Q Owner—CLT ��Addr"ess�1
z By So r* sl•pp V•• 9RG
3 0 CONTRAC70R,AGENT 625 Charles Street
— PhOne�-9� O SJ re San Jose, California 95112
w z WILLIAM
D. I3cN
f State License %�S 3!2Approved EVICy
a o
Lt - U PLUMBING INSPECTOR
FIXTURES
NUMBER=UkJL4P
MAIN DRAIN
UNITS FEES 11
UNITS FEES
Water Heater
/ . J-0 11
Size
Water Closet
. J`0
Material C. 7—
Bath
Bath Tub
/, J-0
To Curb
Shower
=,-av
Ta Prop.—Line
Lavatories
.f .amu
To Existing
Kitchen Sink
/ J7
Not Conn.
Dish Washer
Sewer Box
Waste Disposal
Wash Tra •
STORM DRAINAGE
Washin Machine
/ , JU
Size
Water Softener
Material
Bar Sink
To Main, Drain
Comb.Sink & Tray
To Curb
Dental Unit
Drinking Fountain
Floor Drain
WATER SYSTEM
Hopper
Size "
Restaurant Sink
Material rA L 1 1/• j
Sand Trap
TOTAL FEES
Urinal
Fixture Fee6/ • 3,,9
Area Drain
Main Drain Fee 6-9
Water Leader
Storm Drain Fee —
Sprinkler Valve
Water Sys. Fee J�
Relief Valve
Gas Fee
Vac Breaker
Skimmer
Filter
Permit Fee 'Y.0 O
1 Total