51167.1NO. STREET
N Q
w 2
s ¢
Y O,
¢ LL
o a`
sV
W LL
Io
LL W
o�
a
iN
aW
W
i�
00
> N
0<
ZJ
—U
fcl
Q /3�?/
LOT NO.
ACON FOR BUILDING PER IT
® �M 1 F CUPERTINO
Sanitary No.
Date Permit/No. .3'//& 7
Application i's hereby made for a permit to
�✓/moi»`
a ��s46ry,,IPER Building
to be occupied only as --1; f .L!
Plans, Specifications and Plot -Plan filed herewith.
Estimated Value of Improvements, $ _`71e*►'l �a .
accordance with
P1 Ck Fee
Fee $ 9�, oc
It is hereby agreed that the requirements of the�Cupertino Building and Zoning Ordinances and
all other laws applicable to the construction, location, and use of buildings within the City of
Cupertino will be comp'ied with. DITZ-CRANE
Owner Address Mr I . . nuv earn_
By AddressCANTA ('I IDA Pal lc osncn
State License /J ,79/
ApprovedVVILL1AM D. BENEVICH
BUILDING INSPECTOR
7r /
I(�I��Jl�/ /.I../..1� LOT NO.
NO. STBEE.T
IC p ,FOR PLUMBING PERMIT
— .I F CUPERTINO
o� �� y Sanitary No.
Date 19 1 :�6Jy Permit No 0E//67,
�p Pee $ 4", f V
AppI' s(� eb l Fl of Cupertino for a permit to install plumbing
pipes ar ryfillrr s 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.
Phone�� �'�
State License
WILLIAM D. BENEVICH
1 — U PLUMBING INSPECTOR J
FIXTURES
NUMBER
MAIN DRAIN
UNITS FEES
UNI' S FEES
Water Heater
Size
Water Closet
Material
Bath Tub
To Curb
Shower
/
To Prop. Line
Lavatories
To Existing
Kitchen Sink
Not Conn.
Dish Washer
Sewer Box
Waste Disposal
Wash Tray
STORM DRAINAGE
Washing Machine
/
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
Sand Trap
TOTAL FEES
Urinal
Fixture Fee .
Area Drain
Main Drain Fee :T-4*r
Water Leader
Storm Drain Fee
Sprinkler Valve
Water Sys. Fee /13-71
Relief Valve
I Gas Fee /•S—D
Vac Breaker
Skimmer
Filter
Permit Fee L�
Total
Total Fee G