51167.3 PlumbingNo. .,.�� Stree --� Lot No.
i APPLICATION FOR PLUMBING PERMIT
�tiEC 16 1968 fl CITY OF CUPERTINO
!': Sanitary No.
De Tv /� I-
7. "r %�li\'19C�/i,�j Permit No.2//&' 7.3
at -- • .. � u i/
Fee $,�/,. 5 rZ
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
Phone , el —a���
State License /4PG, f%Z Approved WILLIAM D. BEN'eVICF[
x- Plumbing Inspector j
FIXTURES INUMBER 11 MAIN DRAIN
Units Fees
Units Fees
Water Heater Size
Water Closet l - Material
Bath Tub To Curb
Shower To Prop. Line
v
Lavatories To Existing
Kitchen Sink Not Conn,
Dish Washer
Waste Disposal
Water Softener I I II Material I I
To Curb
Floor Drain WAI
Honoer Size
Total