NO PERMIT NUMBER 10297 Cdld Harbor Ave . LOT No,
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APPLICATION FOR PLUMBING PERMIT
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� Application is hereby made to the City of Cupertino for a permit to install plumbing
o a pip sand/or fixtures listed on tl }es'>fse�9i(Ve t(Crefa r' s to install said prices
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and/or fixtures in accordance with the provision ldf't e.l .lumb Code of the City of
a w Cupertino, and all other laws applicable thereto.
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w Use of Premises HOUSEHOLD.r''``,
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3 Owner RONALD LANGLOIS Address 10297 COLD HARBOR AVE.
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z By SOFTMASTER, INC. AddressP.O.BOX 696, CAMPBELL
CONTRACTOR, AGENT
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— m Phone 379-5050
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o State License 234281 Approved
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• PLUMBING INSPECTOR
FIXTURES
UNITS FEES UNITS FEES
Water Heate Size
Water Closets Material
Bath Tubs To Curb
Showers To Prop. Line
Lavaturies To Existing
Kitchen Sinks Not Conn.
Dish Washers Sewer Boxes
Waste Disposals
Wash Trays STORM DRAINAGE
Washing Machines Size
Water Softeners Material
Bar Sinks To Main Drain
Comb. Sink s Trays To Curb
Dental Units
Drinking Fountains
Floor Drains WATER SYSTEM
Hoppers Size
Restaurant Sinks �', Material
San Traps TOTAL FEES
Urinals I ,f"/j 1 )V I Fixture Fee /,40
Area Drains Main Drain Fee
Water Leaders Storm Drain Fee
Sprinkler Valves Water Sys. Fee /,e o
Permit Fee /, ,ro
TOTAL TOTAL FEE 3 fo
RECORD OF INSPECTION
Underground Rough
Partial Rough
Rough. Complete
Main Drain
Final .