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NO. STA
6
FR :PLUMBING PERMIT' •
SEP 2.7 %tT 01
CUPERTINO
Date S ?f27 1961 195Permit No. 1279
CITY.' OF CUPIsRTIRd Pee $ y
' 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 applinble thereto.
Use of Premises_
:a
Own rI 1 PI. -L- 1-�O�
syl11/c�E2 — �aNt3
� � CONTRACTOR, AGENT
�/f �hone �` L / O � 6 O - T.
4 1 UNITS I FEES 11 - JUNITSI FEES
Hoppers_
Restaurant Sinks I I I
Size���—�
Material
Sand Traps
I TOTAL FEESI
Urinals ;.,
Fixture Fee
Area Drains L,- I
Main Drain Fee It7i l -
Water Leaders I _
I ;Storm Drain. Fee I,,'
Sprinkler 'VarvesI
Water Sys: Fee I \;
SEWER;;XECtI''Per
mit Fee ip L,
TOTAL,,-. I _ _.;'
TOTAL FEE _ IO
G tin. Sanitary ,
Off i, Copy
BUILDING INSPECTOR'S .-OFFICE ?
CITY OF CUPHRTIN0,
`F -J' Sewer Connection - 1 Sanitary Permit No. ,.:._ Me---.......
`ViLam' g: - Plumbing Permit No...........,. //—:.------.
Owner or Tenant
------------------------------ ----.:....
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nt .- D - -------------
.,..0 Tract ---.._....:..._ °/ilrl ✓J/^^//,---..:.---� s— .............._.._.... ...........
Date Connected .............................. ._/.. , -`-------- - ...... -
_ 1 Qe.
Date Final ------`-- - -------------
h1R1\'G INSPEC'COR.
111 1/(,0500 SSS D