51126'-t'�"" LOT
No. STREET
w��9 P AIQ�1 OR PLUMBING PERMIT
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T + ' CUPLRTINO
r o I. I Sanitary No.
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3a ow' -ac �2a7 ,�196a6% -6J Permit No
w a I Pee $
58.00
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APphcc{{lll��fs l2teby rfik o �elr-i of Cupertino for a permit to install plumbing
o a pipes anci'}6r6xtures luted on is 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
a w Cupertino, and all other laws applicable thereto.
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~ Use of Premises Tri-Plex p
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>0 Owner Perrotti Construction Co. Address 2235 Grant Rd. Los Altos
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J, By W. L. HICKEY SONS, INC. Address 198 Commercial, Sunnyvale
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3 r CONTRACTOR, AGENT
- 0 Phone 736-4938
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Y State License #95122 Approved
a o PP
U , f11r PLUMBING INSPECTOR /
UNITSI FEES
ze
Hoppers
Size
Restaurant Sinks
M terial
San Traps
� d TO TAL FEES
Urinals
Fixture Fee 5— �7
Area Drains
Main Drain Fee S, O
Water Leaders
Storm Drain Fee ----
Sprinkler Valves
Water Sys. Fee
Permit Fee o2 ,
TOTAL 3
TOTALFEE
r; RECORD OF INSPECTION
Underground Rough
Partial Rough
Rough. Complete
.lain Drain
Final
LOT NO.
1D�< NO. S EET
z FjA_Z%1ZfIKN
FOR BUILDING PERMITOCITY OF CUPERTINO
o , CT (rI Sanitary No.
I Dare 1 �96% '196_ Is t No.
0
o a (app} licau� is/herle.'§ylnade for a permit to
'z to a at story, Type TIIV S• /1�- ,
�% Building
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to ac occupied only Plans,
1i, df 4i 0
00
in accordance with Plans, Specificati sand Plot -Plan filed herewith. �f✓ .
F; Estimated Value of Improvements, $ 4!(7,0,040 Fee $ /3 3
iJ It is herebyagreed that the requirements of the Cupertino Building and Zoning Ordinances and
, all other laws applicable to the construction, locatiop, and use of buildings within the City of
o Cupertino will be complied with. ) //
3 m Owner-15�7Address
W Wy _7 .T . 7 oC A,
a n By. %�' 12« �� lit C Address.2 2 �
< U Phon G _ F Approve
State Licens — 3_C Yll T_
BUILDING INSPECTOR
RECORD OF INSPECTION APPROVALS
FOUNDATION
DATE INSPECTOR
UNDERFLOOR
FRAME
DATE INSPECTOR
DATE INSPECTOR
LATH and PLASTER
DATE INSPECTOR
FINAL BLDG. j
iDATE INSPECTOR
FINAL ELEC. _
FINAL PLBG. _
FINAL GAS
DATE INSPECTOR
DATE INSPECTOR
DATE
INSPECTOR