NO PERMIT NUMBERLOT NO.
NO:-\\ ��� �STI(EF..."
APPLICATION FOR PLUMBING PERMIT
W a '� , AUG 12 1968 CITY OF CUPERTINO
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o a Date n -., �- '� .�� 196f
3 U I Fee $e3-% 5 Z
Sanitary No.
Permit N
Application is 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
and/or fixtures in accordance with the provisions of the Plumbing Code of the City of
Cupertino, and all other laws applicable thereto.
Use of Premises 1% E % -
Owner�l_. t Address
By C� SVALt1r0e5�'n., 9nr.
.,pp CONTRACTOR, AGENT 625 Charles Street
Phone,% Q'0 SSG San Jose, California 95112
State License/ 7/6 3 7
ad WILLIAM D. BENEVICH
7C PLUMBING INSPECTOR (l
FIXTURES j
NUMBER
p/ MAIN DRAIN
UNITS
FEES 11
UNITS I FEES
Water Heater
Sand Trap
3-vilSize
4
Water Closet
Ap ,%D
46. TO
Material .
Bath Tub
/
J j
To Curb
Shower
Y
/. f
To Prop. Line
Lavatories
.. J-0
,6b
To Existing
Kitchen ink
, U -V
Not Conn.
Dish Washer
Sewer Box
Waste Disposal
Wash Tray
STORM DRAINAGE
Washing Machine
/
,V"D
Size
Water Softener
Material
Bar Sink
To Main Dr
Comb.Sink & Tray
To �u
Dental Unit
Drinking Fountain
Hopper
Size"
1
Restaurant Sink
Material (-
,V J
Sand Trap
TOTAL FEES
Urinal
Fixture Fee
Ap ,%D
Area Drain
Main Drain Fee
V700
Water Leader
Storm Drain Fee
—
Sprinkler Valve
Water Sys. Fee
/. f
Relief Valve
Gas Fee
.. J-0
Permit Fe
Total Fee