2742 / p�� LOT NO.
NO. _/ r STREET
D �1 FOR PLUMBING PERMIT
¢ I Y OF CUPERTINO
x a MAY 21 1964
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Sanitar No,
LL
° a Dace 196_ Permit No
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W 01• Fee 4.00
LL
CITY CUPUTIAI'�
° Application is here y o th City of Cupertino for a permit to install plumbing
o a pipes and/or fixtures listed on the reverse side hereof, and agrees to install said prices
i N and/or fixtures in accordance with the provisions of the Plumbing Code of the City of
¢ w Cupertino, and all other laws applicable thereto.
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LL Use of Premises Residential
00
3 Owner Richard Lindsay Address 10826 E. Estates Drive
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Jz By Lindsay Soft Water Service Address 351 Meridian Road
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3Q San Jose, Calif.
- W Phone 292-8497
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6
a o State License 21209Approve GILD
C) ��� CONTRACTOR, AGENT
X/
FIX R : MAIN DRAIN
UNITS FEES UNITS FEES
ater Heater Size
Water Closets Materia'_
Bath Tubs To Curb
Showers To Prop. Line
Lavatories To Existing
Kitchen Sinks Not Conn.
Dish Washers 11 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 I
Hoppers Size
Restaurant Sinks Material
San Traps TOTAL FEES
Urinals Fixture Fee 1.00
Area Drains Main Drain Fee
\hater Leaders Storm Drain Fee
JPrinkler Valves Water Sys. Fee 1.00
Permit Fee 2.00
TOTAL 1 14.00 11 TOTAL FEE ,00
RECORD OF INSPECTION
Underground Rough...
.Partial Rough..
Rough Complete..
Main Drain (
Final... t cl`