2735 - PLUMBING / G
Loi kn._.1.
N0.
a C MFOR PLUMBING PERMIT
OF CUPERTINO
W
R
o ?f MAY 7 1964, �, Sanitary No,
3 a Date 196_ Permit No 5
=LL �Y 0� �UPF�RTINO Fee$ . rod
o App( tion Ps ere y ma a to the City of Cupertind for a permit to install plumbing
'o a pipes and/or fixtures listed on the reverse side hereof, and agrees to install said prices
i m and/or fixtures in accordance with the rovisions of the Plumbing Code o6 the City of
a W Cupertino, and all o laws applica a thereto.
w I
� r
LL Use of Premises
00
o a Owner Address
ZJ
J o B CONTRACTOR, Errr Address
3P
— 0 Phone
ImState
icens Approved PLUMBING INSPECTOR
UNITS FEES UNITS FEES
Water Heate 00 Size _O r
Water C osetS 00 Material
B4 Tubs ° a To Cur
Sh veProp
ers - To . Line
L atones o To Existing
K t,to Sinks o J Not Conn.
DGRWashers Sewer Boxes
Waste Disposals
as'h Trays STORM DRAINAGE
Washing Machines 00 Size
Water Softeners Material
Bar Sinks To Main Drain
Com . Sinks rays To Curb
Dental Units _
Dnnkm�g Fountains
I'oar Drains — WATER SYSTEM _
uppers size
Restaurant Sinks Materi 6
an raps OTAL FEE
l�rmahs— Fixture Fee Od
rea�rain—'s— Main Drain Fee _
Vyater Leaders Storm Drain Fee
Sprinkler Valves Wate Sys. Fee
Permit Fee a
TO'T'AL Q TOTAL: FEE OU
RECORD OF INSPECTION
Underground Rough... '
Jamal Rough.. �r —
'Rough, Complete.. •�,
Main Drain =' —
F Taal...
Bldg. Dept
Office Copy
BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTINO
F� Sewer Connection Sanitary Permit No. ..S.W-7.........
UY00'PImbi,g Final Plumbing Permit No.*:XZ?-1F-----------
Lot No. ..'
Owner or Tenant --- ....... ....
.. ....................
At ...... .:::216 . .........................
Tract ........... Ak........................................................ ..........................
Date Connected .............................. . t
................................................... 19.W
Date Final ..................................
................................................
...................
PLUMBING INSPECTOR
Ill 7/63-IM