1054 • ia31 C' d
,tt�
o - APP '.TION FOR BUILDING-PERMIT .,- .,
-4 I,z� (LCITY,OE'CUPERTINO '' -• '(' -76E
Date . • .EU)-'I. . 1 „ 195 -'.:c' .• _
7- • Permit.No. (OStl
. Application is,fiereby-made for,aipermit'to },b._C7C,�.-0
.6-#1,:::•4^4:-.
a
62-A\42_- I story;,Type .i /1 Building.
ti) at _( A V—js
•-.. , e• --- t� 1.\
JI to be occupied only as A.4. v'+ `; ' I — r -]
I. in accordance with Plans,Specifications and Plot-Plan filed herewith.
r 'e „ (Q — toeal
. S. Estimated Value of Improvements,$'. —2°.‹ 1. i Fee$ I h� • '
44-''.
? ❑. It is hereby agreed that the requirements of the Cupertino Building and Zoning Ordinances and -
' "mak• all other laws applicable to the construction, location, and use of buildings within then City of
..a Cupertino will he complied with. -� . Il� ,
1 ( r`
9 Owneri�It k Is ti,lig'.:I '. <iet.\ In A\ Addres___1')
�i�� '« 41 kilo ..�.••i. i'
In _ •
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C By`-t ve ,.c1:as-... AddresslG74 c -L - t'\- r - •
` C i CONTRACTOR, AGENT 'C f_ I r r- s'
:I'°Phone ri. IS r'1 (V-AI t�- := Approved a ' { i �1 bc, {
I 1 BUILDING INSPIECTOR , 1 !
(/-1;€411.0tt4 ate't 7 4VG-t ,,/,$' lr,
(7 RECORD OF INSPECTION A' PitOVALS
J. ,- r
FOUNDATION /4//// � - '�.c '�
DATE/ INSPECTOR ,
ERA.I(F�' .042 f
��/yi1�'bl*.!:'�,^r„*3 DATA /� �'-) INSPECTOR •
Illv///wvv�ii, -.� V/ Y
(ATHIand PLASTER '511/2(:/ �� 7
DATTE ,�• INS PFM OR
I7 fNAL BLDG. 7/.3!ls/ I '��
DATE. / INSPECTOR
FINAL ELEC. 7/3/6' w�►
AT INSPECTOR
FINAL PLBG. 7/4/ � �!��
/7,(!DATA� / SPECTOR
FINAL GAS
DATE. INSPECTOR
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- CERTIFICk•tE OF • COMPLETION •
... ...
BUILDING INSPECTOR'S OFF IE- it 1,' --r
CITY OF CUPERTINO -'7.1-%--j..C.
•.
• I. ; • . ,i I I . :r • - /
Date 7.4:-' , 194" r Building Permit No/26 '
•••-)
i
The Building Located at fir.,— 'I,. ' — • ..C2IlTh...2C-r...-.--"4.4Z-4'.
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1 .-• Owned by it -..- • .-t-4.--7-1--:"..-•.:1-0 . •
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p ./
ttom 1 -
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Has Deed'--.(Altefed) For Use As:. ..tf.: - 4. • f.• •
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BUILDING INSPECTOR . -• .4"`1...,
10? 4'61-500 h
_ . . .
NO. STEET t. LOT NO.
•iLAPPLICATION FOR ELECTRICAL PERMIT (•
1 rl CITY OF CUPERTINO
y
Date ��� -� �f , 196E - Permit No. *1�
T A.:
' _ Application is hereby made to'th City of Cupertino for a permit to install electrical
wiring and/or fixtures as listed on the reverse side hereof, and agiees to install said
wiring and/or fixtures in accordance with the provisions of the Electrical-Code of the
iI City of Cupertino, and all other laws applicable thereto. 'r.
v Use of Premisec PitY
c /
:7 Owner yy i ^ _T Address
td $y -A! l•`i ••,rr•rtl 1. n Address J� I//�
CONTRACTOR, AGENT ? / V �•
( V - Approved - t-I AA 1 A•• .• ..L •
j;h ine: (1 r Hl�r'1/ • ELECTRICAL INSPECTOR % t
y
r I q .1
NEW RPL r FEES
Size Service Conduit /1'4f Number of Outlets 33_.._ � -3J
Size•Service Wires Y Number of Switches 36I'
Size Service Switch../ Z..11 Number of'Rece h s Jw."•`�'' - d>>''
. P ;11iSire Sr.?ubd.Conduit °'-' '''• •"'I Number of,Fi"xfuiep!}_'•_ �'+'t y y i ti
1 • -Size Sub Feed Wires Ranges-.... KW:;;;2:.?---. . 24r
E. Nrunber•of Gircuifs'=""w" '4 " Oven "�'�•-' ;�KW .!i fT . 3ot. ,2,j ,
:....1.4.. Number of Meter• ..n -�r.4 Signs Transformers :4,4 .---4,-,•;4.4..4 a ..
Misc 7 m.a Dryers- 3i.'+ _ ...7-. :•:•.‘
:Motors •
HP,• Phase _• ,,,. . t73
Motors '� HP Phase -• - Permit Fee :11.0077-, ._
w-u. a s . - , -.
•
Mi ors "' - i''1115-#"- Phase H P Chaise I °- '-' '• ,
. * ' TOTAL FEES
CORD;'OFZ INSPECTION f1PP O moi,
Rough Wiring:V/9Ra Vii-°>� Fixtures- �l____1 ___�_ ��=� ,
�f�1�
r�/
Finish,Wiring7 ..41( 40° Motori"7 ,t4/ I a�y
.trataR
.. DAre .. Ixsv[eTae
. . ., . Final -../-,. �.r I (_ .i l
DATE � INSPECTOR
, •, "......w
• , - .._ .
C4
rvkli , , d ELE:CfRIC SERVICE NOTICE OFFICE
copy
i. ,it ,-. , yiti. . . ..,BUILDING INSPECTOR'S OFFICE
..- ''': ./. - f•'.:q4CITY• •
„41., ."' . • i e .. 4. ,...,;e.,, v v,.., Of CUPERTINO. • ..str a.
/ • .'11- -;.‘-----';- /1- ' ' .%; .- ••:t-e, ,
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Tor ?.."2. ,,,,z,.;.:.e -
ThleT.;;:iii;"I:141T.'w.b'ii%Pw bA' '• a c ESIFiEciiiie: - • for- ' . - —
.. . . .,t, ou are .ere y au.Epz.e„:,9..g.lilec.:t ue ra sen • :„•, :-4‘.. •
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3. . 7,:e/FI ,72.>" A.S.449::17 4421654A:Pt;4:#4::+47{;... "
Owner or;Tenant .,-.1.
At•! ./4",---?;‘,.:-C--• .%-:-.Lors ,
-i. .... .
.)-, .e ate:9,7 . • .
.No. of Wiles - a•;..:
Size of Wires2' 4.1.:SizeTof•Switchla07,71-.'
1. _ .. .s.
I - • ' 1
Motor Load
• -: • . Voltage
Heating Load ',. ,K W1 • t. •-•t"-1-#-_:"f-o41.Voltage ...
I. •.,
II .------ R t
Light .• 110 1> New SerVice. _ crooner
I; No. of Metei:tr ..1 kley.eLci:;:.,_ • 220 Three-Wire: ,: Move Service
I: • No. of Add.7Meters- -'
7 Povreh- t'-'••-' -.,.0 Ths•e Ph se Move Meter
r
.
. ....- - -.Cr' -0.
-' (c — ) 42,---1 .
.
•k- -
,,-
,... ....
1o4 1/60-500
; 6.,....ELECTRICAL INSPECTOR
,
•
/9365 I einf.::„...„,,_,,...,.--
• - LOT NO. A !
NO. ' STREET • I • -i a . '- . +
APPLICATION FOR PLUMBING PERMIT,/ •;. =
CITY OF-CIIPERTINO 'f, ,• r
' • Date ' . "/ >' 195. • A Per No:f L' 's fi 2
a .v
_ •s---:.t Fee $ /7__dr • ---I_ _,..t:;,__ _ Application is.hereby made to the City of Cupertino'of;a;•peimit%to,'install•plumbing .:•
p, pipes'and/or fixtures listed on the reverse "side•hereof, and.agrees to install said prices
% •and/or fixtures 1t1Radbidan'ce'svith the provisions of:the Plu/nbin'g CdHe'of'tlie'City of. .
Cupertino, and all other laws applicable thereto. •
. r., .;,�., C 5 . :Vi: •/.' , e. / w ..r
u•`.Y_,•-- Use of''Pietnlses ri�'%��'3 f i�r'-dam .r" c!�1-[.
47 1
a
"r41:1-#.,4..4%114-,i2t .a.4.4
u.,-76 Owner //A& ni) X:.e..nt?I2 :Address i1 /2/4:4 -e.c' l94”-,d j.
/� '
By / 15 2 /� - ., Address/r).27a�.Ut /
' i
y
CONTRACTOR, AGENT / ' /
Phone ''.,'-.5i</V r :ApprovedOt l A .11.4 4 1 , SIR h,,
e /--13 ( PLUMBING'INSPECTOR it '
•
FIXTURES j NUMBER MAIN DRAIN
I UNITS I FEES II I UNITS I FEES
Water Heater I / I Size /4" j
Water Closets j j Material Q/
Bath Tubs / j To Curb
Showers j j To Prop. Linevl'
Lavatories 2 j To Existing/
Kitchen Sinks / j Note./ �'4q/4
Dish Washers I SEWER BOXES 2 5_
Waste Disposals j j -
ash Trays STORM DRAINAGE
-Washing Machines et Size
Water Softeners Material
Bar Sinks •To Main Drain
Comb. Sink &Trays j To Curb j
Dental Units _ I ��• ..-
Drinking Fountains jl tom.
—
Floor Drains WATER SYSTEM.,,it }
Hoppers Size /' n-1
Restaurant Sinks Material qr./ti,; ' j
Sand Traps TOTAL FEES
Urinals Fixture Fee / c
Area Drains • Main Draih Fee j _,;,
Water Leaders Storm Drain Fee
Sprinkler Valves Water Sys. Fee j /
Permit Fee
TOTAL ,Q >4 /,50 TOTAL FEE /9
R ORJD 0 it.
Partial Rough / 6
Rough Complete
Final IF/ -4/ citi
----nnamminmer
llir
I 'J 4.6I 1 -O
/ /l� L; LOT NO. /9
- -�--
NO. ' STREET • •
APPLICATION FOR PLUMBING PERMIT • •
CITY OF CUPERTINO -.
Dated /- 4", 195 / Permit-No. JOc$`\: ,.�4'.' •
1.
Fee $ /e).OU
Application is hereby made to the City of Cupertino for a permit to install plumbing
tC' pipestand/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.
8 Use of P{!mises cPl -t-r/ /t'-e' - 644r c
',111 • 6/1.;/-r---.4.4.4-c...:.:. ...__... .cTc-t d cz it
w
1......
Owneri`/7'7 p' k<-<-e-c'A-- Address
By c e �p7_ Address / / • '
CONTRACTOR, AGENT (-- ! .
Phone-- -2Approve& s 1 /i/lti'ii i•/ •. '1,4•
_ PLUMBING INSPECTOR
•
FIXTURES j NUMBER MAIN DRAIN
UNITS I FEES II UNITS FEES
Water Heater / Size
Water Closets / I Material
Bath Tubs / j To Curb
Showers j To Prop. Line
Lavatories / j To Existing
Kitchen Sinks / I Not Conn.
Dish Washers j SEWER BOXES .
Waste Disposals '
.Waste
Trays STORM DRAINAGE
ashing Machines / I Size •
Water Softeners j Material' j •
Bar Sinks j To Main Drain j - j
Comb. Sink &Trays I To Curb
Dental Units
Dtirkking Fountains _ jl
Floor Drains WATER SYSTEM
Hoppers Size
Restaurant Sinks Material ' .- `1
.Sand Traps . TOTAL FEES ,
Urinals Fixture Fee j 9 oe
Area Drains - Main Draih Fee j
Water Leaders Storm Drain Fee
Sprinkler Valves Water Sys. Fee
Permit Fee ", e
TOTAL /n /.SD TOTAL FEE i
RECORD OFFI*SYEcTION
Partial Rough //2q / ^�
Rough Complete ,,,g/ off'f tL-t
Final 7/3Ai '`� .
/ OS I Arris—.ate... LOT NO. /7
NO. ' STREET
APPLICATION FOR PLUMBING PERMIT
CITY OF CUPERTINO q
Date - , 1950L Permit No. � Uclar
•u
Fee $ /0.00
4\12Applicationis 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
•,,,4 and/or fixtures in accordance with the provisions of the Plumbing Code of the City of
\??tt Cupertino, and all other laws applicable thereto. .../
vUse of Premises , A. Th--/ /..'_, - da, .5
n owner--;int, /�i�t-to / Address /
By /� (a . Address ,I 1
/+e CONTRACTOR, AGENT.. �f` tI
'} Phone , �?-4�i tecC _ Approved t �•�I\ ` 1 i a
v3 I PLUMBING INSPECTOR fr
FIXTURES NUMBER r; js, MAIN DRAIN
•
. I UNITS I' FEESfII 15k I UNITS I FEES
Water Heater A •r :1,1C'lit.e-
Water.Closets 1, yv.;jj ::material
Bath Tubs /1' ."yjj d 9u46 •
Showers' - _ e •wjs .!'jn,.o. RO p. Line
Lavatories •r 'i: /I' - .4 acv& sting .,
Kitchen Sinks' %'„ - ;!:. aot?in.,-
1 Dish Washers iI r. , `.' CI BEWeR Anxpq
Waste Disposals -li `l� j •;Ci
Wash Trays STORM'DRAINAGE
Washing Machines 4, Size:;,
I Water'-Softeners '. j Material j
Bar,Sinks .11 j To Main Drain 1 .
Comb. Sink & Trays j To Curb
Dental Units <. .r . •,
1101111—
Drinking Fountains _ ;
Floor Drains WATER SYSTEM
Hoppers Size +Ih _ j j
Restaurant Sinks • Material 1 - j
Sand Traps • ;TOTAL FEES
Urinals • Fixtuie Fee; / I 9,cc
Area Drains Main-Deaih Fee j
Water Leaders • • Storm•Drain Fee j
Sprinkler Valves Water Sys, Fee I ,
- Permit Fee j i. c
TOTAL j I v /,Ec TOTAL FEE ,, , .
RECO D O. . CTION _
Partial Rough //?r o/ '
Rough Comple j_ dir e .•
•
Final 7�SA,/ ! •
,• •
-- n
_ .. ,... ♦ri _.
- - Cupertino Sanitary
•-rt:'--'� Off!r Cony..
.BUILDING -INSPECTOR'S OFFICE
"CITY OF.CUPERTINO
t ,?.j ..j. u s ._ '
-
,❑- Sewer'Connection" .:,...,.. ..4., Sanitary 'Permit No -176'6••• -
; 6 ] Plumbing 'AIin,!a•
tnal•J„:7,..4-,z
;, , c.fin ' .4c 'v'
-vs.. Plumbt.tpg Perm[tL.o.Ns4:2 !J*-fe7/0 24„
i :• • " CJS.,4 N O �t +tae..•,.:
On net or-4-t,,_.-
ennt /,/f �f//f `�c
t+ .,Fiw O.. gam„ . .C—''',A�-' :ler,C40_,
,"7.4r.+� �J.�� i:.,• ',:Is:,�'"> =_: •
Tract * ra5 i: •-4o--"v6-~‘'‘
• Date Connected l O. - 1�,(�•
y
.. Date Pitial ay /._.a - 19-4/.
C. ,
` t/. p1:U
- MBING INSPECTOR
ttt 1/60-500 _ 2.° •
�; // 3 iCer. i-tz--n.�Q6'J LOT NO. - A'
.k: . NO: • .4y-' f STREET .. . .
APPLICATION,,FOR GAS PERMIT •
Y•
CIT 'OF;�CUPERTINO •
}._ a
L. _ Date - --� -J=-'y s 1912_24• Permit No. �• , t •'
Ht--
,
•
4• . # k-'' _ ' -- ,�, Fee;$ �>' �� . M1�<.
-r. n Application iiss.hety, madmen the Sty,o C9 e -inor , rtlyto install gas pipes`—2
ii,kR%� :: and/or gas applian aas listed_on theireeverse sld'e e ndYagrees-to mstall'said pipes "
7 fit. and/or appliancesria ctoY withjh pr�ov o he)Plu(nbing+Code oftheCit} `-:
t'f Cu rtino and.all,other,laws-a licable thereto.__—.." "4'S`.�-" ✓' ., •-'•
f o '
lR — Pp
•
8, Use of Premises 4c'ce - •...!--
%.:—....•
. _ +. - • l
•1 '� X4-s7�io4.4.e ZJJr% � -e �_z d, •
ti
h Owner � �//,/./��ter✓ `�r.ni. Address lye/ •i'e-tl��,✓�,,c/-�'.�✓Ze.'i'"'••'a
Y ft ,�gy ^�' A �r iC'• Address Ad 9 7 .e9el �f -i-
&,,,,
-
'
/,/ ,/ • _ CONTRACTOR, AGENT pp y7- 1I\- ,I' '
`� V Phone 'i-�- .2-r1/"A'1 A roved
PLUMBING INSPECTOR I
Remarks (Check V)
Type of Appliance Units Fees New Replace I Relocate
Gas Ranges
Wall Heaters
Gas Plates
Circulating Heaters
Blower Furnaces •
Gas Fired Boilers
Warming Ovens
Percolators
e, GriddlesGriddles
Steam Tables
Gravity Furnaces
Suspended Unit II -
Floor Furnace
Miscellaneous % i
(NAME TYPE)
Appliance Fees
' Inspected and Approved •
• DATE INSPECTOR
HOUSE GAS PIPING
Number of Outlets I f Size of Main I 11/4. "
Gas Piping Fees I
Tested and Approved ..lam //6/ - -
•
IATE INSPECTOR
it
"9.364 SC///-4 Air>edit/ LOT NO. J / -
NO. STREET i• -
APPLICATION FOR GAS' PERMIT
CITY OF CUPERTINO
F Date ^'•'179" — 19 L Permit No. ' I 1,f
4' I„ Y k , 0:O o
1" , Fee $
�. SVApplication is hereby made to the City of Cupertino for a permit to install gas pipes
t" es, and/or-gasppliances as listed on the reverse side hereof, and agrees to install said pipes •c
�(\ and/o?-appliances in accordance with the provisions of the Plumbing Code of the City
of Cupertino, and all other laws applicable thereto.
„
n }7
Use of Premises ! — aa• oZ
r Owner /nit - / Address ^.
t By ,. �n - � Address I �c iir,
1�� l/'� CONTRACTOR, AGENT t� IAL
iI { I',
' t�hone /-�' - -2--S-/ya= - Approved Jt'/y
PLUMBING INSPECTOR
Remarks (Check ✓)
Type of Appliance Units Fees "New Replace I Relocate
Gas.Ranges
Wall Heaters
•Gas Plates
Circulating Heaters
Blower Furnaces
Gas Fired Boilers
Warming Ovens
'Percolators
Griddles
Steam Tables - •
Gravity Furnaces
Suspended Unit •
Floor Furnace _
Miscellaneous •
(NAME TYPE) -
•
Appliance Fees •
Inspected and Approved
DATE INSPECTOR
• HOUSE GAS`PIPING `"' <1"
Numbei of Outlets 7 I Size of iMain I i _
GasePiping Fees / _�
Tested and Approved .W..7/6l .101
DATE , INSPECTOR
' •
/7_44-5L/in.045-Pti' LOT NO. -1I
NO. ' STREET
•
•
. APPLICATION FOR GAS PERMIT
CITY OF CUPERTINO
i y
► t --1/:Date ./- � , 19f / Permit No.
C) Fee $ oRo0
•
Application is hereby made to'the City of Cupertino for a permit to install gas pipes
IC and/or gas appliances as listed on the reverse side hereof, and agrees to install said pipes
and/or appliances in accordance with the provisions of the Plumbing Code of the City
' ' of Cupertino, and all other laws applicable thereto. .
8 Use of Premises a/1.4- c! Ac..o. - Cie,... '
a
.v. � -F.��:.//�cci�..1�Gc-.✓/.6lic-G!/, mow.-c.e-�;v
in Owner ✓Jf�/!'rp't�• /Cc��• t-c'� ['// Address
? .By /7 Ct It - , f t� •• Address j
h. 2 CONTRACTOR, AGENT' I nt.•
'}
j!`'' Phone &i. a-Si av Approved s.
IPLUMBING INSPECTOR I
Remarks (Check d)
Type of Appliance Units Fees New Replace Relocate
Gas Ranges
Wall Heaters
Gas Plates •
Ciiculating.Hearth
I •?Blower Furnaces I
Gas Fired Boilers-
Warming'Ovens
percolators •
I.>Griddles
Steam Tables
Gravity Furnaces
Suspended Unit
.Floor Furnace .
•
Miscellaneous
tl
NAME TYPE) '
o
- ti ;
Appliance Fees •
Inspected and Approved k II '
DATE 1 INSPECTOR
HOUSE GAS PIPING if. ')1z2
Number of Outlets' I 7 I Size of Maint ' "
Gas Piping Fees I era,'"
/ '‘40-4211:1;'' �
l<
Tested'and Approved -..
D. �.
DATT E INSPECTOR '
1 /93k.•( ' 4.,,LOT NO. /7
Na „ - / STREET
APPLICATION FOR APPLIANCE:,PERMIT
CITY•OF CUPERTINO
Date_ 196 Permit No. J? 7
St ,;
iii:. , ,
Fee $
f:' d Application is hereby made to the City of Cupertino for a permit to install
` 3 gas appliances as listed on the reverse side hereof, and agrees to install said •
"3 appliances in accordance with the provisions of the Plumbing rode of the City
of Cupertino, and all other laws applicable thereto.
1
c
fit Use ofPremises
41_,..:6/7
J�n OwnerAddress/ W � 7i .// .111/4-in
—qtyBy/O t( .e�f' - Address `'1 J I r I//; `• `1 �...
� / CONTRACTOR, AGENT " 11 i e f p
�',`Phone t-� �li� cI I Approve . .• ! t '
/ PLUMBING INSPECTOR
`r
Remarks (Check J)
Type ni Appliance I Units Fees I New, j Replace j Relocate
Gas Ranges j . e
\Wall Heaters [SC ✓ r
Gas Plates j
Circulating Heaters:` •
Blower Furnaces / ✓
Gas Fired Boilers •
arming Ovens
�.,P 4c*tors
A
° Griddles
Steam Tables j
Gravity Furnaces j
FloorpFur Unit II
Floor Furnace jj
. jl
Miscellaneous 1
(NAME TYPE) j
• 1
. j a
. pp iance'Fees .y
iii:
Inspected and Approved .-. .��;- r� •
' DATE INSPECTOR,.. i
•
y
.
GAS SERVICE NOTICE OFC
`-< - FI
BUILDING INSPECTOR'S OFFICE
/ CITY OF CUPERTINO
• p7 196.l.
To
• You are hereby authorized to connect the GAS service for •
Owner or Tenant ....Zed: ,Ci
,
At .../2S5 ' i._`. i i J . --- ee,
• New Service
• No. of Meters ....t • Reconnect
-___.—�.._-, - Move :Service
.% c
t ....•. , .;• No. of Add. Meters ' Move Meter --
.._. „
- -
, .
•
. •. .. .
• i•,.
• PLUMBING INSPECTOR-
110 1/60-500 •
Ty
1 .J yy`` 7 •
.• a ',. -_ :__a, LOT ANO.- - ` 1
NO. STREE ` '
I
APPLICATION FOR PLUMBING. PERMIT
" CITY OF CUPERTINO ' •s. ' .•- -•-
'A Date , 195_ • Permit No. �N K�
I.
i
� ^ .
Fee $ �` ~`
r (4 . Application is hereby made to the City of Cupertino for a permit to instill plumbing
pipes and/or fixtures listed on the reverse side hereof, and agrees to install said prices
and/or fixtures in acc ce with the provisions of the Plumbing Code of the City of
` '
' Cupertino, and all other law applicable thereto.
8 Use of' remises ' `
o) til
" eil Owner AZl � �" J ' Address// /&C4( - 1�/ ,
•
Byc- 4e- _ Address ,. ' ,• tt il
CON CTOR, AGENTear-, R�
Phone ribig /39'6 Approved �:_z CT �= ?
. PLUMBING INSPECTOR ' ( •'
FIXTURES I NUMBER i • MAIN DRAIN
. I UNITS I FEES 1 'I UNITS' FEES
Water Heater I Size
Water Closets I . Material I
Bath Tubs To Curb : • f •
Showers, I To Prop. Line
Lavatories - To Existing
Kitchen Sinks - .. • Not Conn. ,
Dish Washers SEWER BOXES
to Disposals •
W 'ham Disposals
STORM DRAINAGE
k h fachines Size : � . '
Water Softeners l Material
Bar Sinks I To Main Drain I '
Climb. Sink &Trays .' 1,'To Curb
I Dental Units • - '' OS WDrinking Fountains - 1 s - �
Floor•Drains WATER SYSTEM
Hoppers Size
Restaurant Sinks Material I I
Sand Traps TOTAL FEES 00
Urinals Fixture Fee. ' l ,/
Area Drains Main Drain'Fee 1 •
I.
''Water Leaders Storm Drain fee 'I+: ''!
' Sprinkler Valves / a- Water Sys. 'Fee .I `,,
ce
Permit Fee IsA•s
' TOTAL • TOTAL FEE L• ��—�-
RECORD OF INSPECTION
Partial Rough '.:4.;`‘
Rough Complete ��, "
' ' . %2 ,
Final Alpr!i • "..,,.r,. .
1
. - .' i ,