2295 �� ✓ �-���11 LOT NO.
NO. STREET
® A •PPPPLIOA ON Pit PLUMBING PERMIT
CI F
JUL 0 1963 `
MI Date...........y 196- Permit No. 4qc-V�------ -
CITY OF Cl------�'�' Fee $
Application is hereby made to the City of Santa Clara for a permit to install plumbing
{b pipes and/or fixtures listed on the reverse side hereof, and agrees to install said pipes
t11 and/or fixtures in accordance with the provisions of the Plumbing Code of the City of
Santa Clara, and all other laws applicable thereto.
jUse of Premises
v B
A ��5
Owner .../.✓..--- - �' - -------.............. Address- -- - ------------------------------
KEN'S FT WATER INSTALLATIO, CO. Add
02
(�./.•. 3. eqNcAV....._T._S....-__b.._.•p. R
W_R..__.A_G_E._N.._T
---------------------
LOS
--------------LOS CALIF, 3789060 kpproved .... . . —
I PLU ING INSPECI'O
--I`IXTURES�NORBfA� R N
UNITS I FEES UNITSFEES
Water Henter I Size
Water C osets Material
Bath Tubs To Curb j
Showers To Prop.—Line
Lavatories To Existing
Kitchen Sinks Not Conn. 1
Dish Washers
Waste Disposals ( ��
Wash Trays ORM DRAINAGE
Washing achines Size
Water SQilgnersj Material j
— To Main Drain
Com . Sraysl 1 11 To Curb
Units i 1 11
Drinking rountainsi 11
Floor Drains �� WATER SYSTEM
Hoppers IF Sae
Restaurant SinksI II Material
Sand r'I aps— I TOTAL FEES
" Urinals Fixture Fee
Area Drains Main Drain Fee
Water Leaders torn Drain Fee
Sprinkler Valves II Water Sys, Fee I _
Permit Fee
_TOTAL TOTAL FEE
RECORD OF INSPECTION
Partial Rough
Rough Complete
Final