631 (2) LOT NO.
STREET - 4.
APPLICATION FOR PLUMBING PERMIT 0 )
��y�
F� •L OF CUPERTINO C �J
/ 11 p
Date r JA N 2 0 1960 ">'/195— Permit No.
00
�+ Fee $
ApplliV�/cation is her&y made"te'th 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 iia;accordance with the provisions of the Plumbing Code of the City of
Cupertino, aridill other laws applicable thereto.
Use.'of.Premisesi=,�^
Owner / m • Address
•'- Bp.::.'/ .. Address
.' -_.,�„CONTRACTORS AG T H
M � ApprovePIL.WAM D. BEN VICH
Phone — PLUMBING INSPECTOR
i FIXTURES NUMBER MAIN DRAIN
kI UNITS I FEES 11 q JUNITS1 FEES
Water Heater I / I 11 Size j
WaterClosets I Material C� j
Bath Tubs / j� To Curb r— j
Showers oe To Prop. Line j
Lavatories j j To Existing
Kitchen Sinks -42M Con
Dish Washers
Waste Disposals
Wash Trays ( STORM DRAINAGE
Washing Machines le Size
Water Softeners Material
Bar Sinks To Main Drain
Comb. Sink &Traysi j 11 To Curb 1
Den[51,Units I 1 11 '-�
Drinking Fountains] j I�
Y Floor Drains �j WATER SYSTEM
Hoppers j Size
Restaurant Sinks Material
Sand Traps j TOTAL FEES
.Urinals Fixture Fee 1�/0 o2
Area Drains Main Drain Fee Q Q
Water Leaders j Storm Drain Fee j
Sprinkler Vawes j jj Water 's.
Fee
Permit Fee
TOTAL /n TOTAL FEE / Od
tlREC RD OF L SPECTION •'-o
Partial Rough i1 _
Rough Com let n" —�--
Final
♦� _ CJpP.tino a]nitary
Office Copy
BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTINO
Sewer Connection Sanitary Permit No. ........
ER'Plumbing Final Plumbing Permit No. .......(P �..........
jLot No. ......
Owner or Tenant .......sA04�.. - ..`k�.:. ......._... ��........ .... ........
nt ..... .13 .:r..: t ..��!tf, ..C.rl
,..._.
i
Tract .................... !Y.' r .".. J...............---...............................
DateConnected ....................... ..l... ..........................
DateFinal ......... ....................a2 ..¢c!. ................. .................................. I9.6p
r
MBING INSPECTOR
1II 7/59-500