5174 10184 I .C�.—�olby Ave LOT NO.
NO. � �`TR
ET
APLIT
I7CORFOR PLUMBING PERMIT
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OF CUPERTINO
r o f UG 0 960 [v Sanitary No.
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a a Date 2, 1968 Permit No ��1 �� `�
4 CITY OF CUPERTINO Pee $ 3.50
0 Application is hereby made to the City of Cupertino for a permit to install plumbing
o pipes and/or fixtures listed on the reverse side hereof, and agrees to install said prices
r 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.
Use of Premises Residental Swimming Pool
00
, 3 OwnerBisson. Calvton Address 10184 Colby Ave_
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z J
� z By DELTA P .
1MRIN & P P i TNFS�INaddress 306 niahl n RA-
O CONTRACTOR, AGENT Danville 93426
3 �
- 0 Phone 837-9631
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m w WILL1.4r.1 D. EZi-. VICI-1
u s State License 249299 Approved
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—V,I PLUMBING INSPECTOR
FIXTURES 'NUMBFR MAIN DRAIN
UNITS FEES UNITS FEES
Water heater $ize
Water Closet Material
Bath Tub To Curb
Shower To Prop. Line
Lavatories To Existing
Kitchen Sink Not Conn.
Dish Washer Sewer Box
Waste Disposal
Wash Tray STORM DRAINAGE
Washin 67achine Size
Water Softener Material
Bar Sink To Hain Drain
Comb.Sink&Tray To Curb
Dental Unit
Drinkin Fountain
Floor Drain WATER SYSTEM
Hopper Size
Restaurant Sink Material
Sand Trap TOTAL FEES
Urinal Fixture Fee
Area Drain Main Drain Fee
Water Leader Storm Drain Fee
Sprinkler Valve Water Sys.Fee
Relief Valve as Fee 1.50
Vac Breaker
Skimmer
Filter
Permit Fee 2.00
Total Total Fee 3.50