51089.1 (3) p3 . 21230 I West Homestead Rd. LOT NO. Bide. 0
NO. SnEF.T
AP 'I�TI t tOR PLUMBING PERMIT
W d Y CUPERTINO
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' 0 31 19 ( �1 Sanitary No.
LL !2(Q9Y88
o Date 5I - Permit Nn' sic"
u ! Y Fee $
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r CCn
o Application is hereby[ detn'?L�e�G� 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
> a 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.
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LL Use of Premises apartment
O ° 801 American St.
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Owner Herman Christensen Address Snn
0 3
z 2301 Palm Ave .
zj D J. W. McClpnahan Address
J O y Co.CONTRACTOR, AGENT
3 ` 345-1691
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Phone WILL D. BENEVICH
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State License 133158 Approved
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¢ a
—U PLUMBING INSPECTOR
FIXTURES NUMI3ER F MAIN DRAIN
UNITS FEES - UNITS FEES
Waterlleater 3 7.io Size
Water Closet 16 .�`l— Material ,3 911
Bath Tub /6 ?y— To Curb
Shower To PM2. Line v
Lavatories 16 RSI— To Existing
Kitchen Sink /6 Not Conn.
Dish Washer / Sewer Box
Waste Disposal to
Wash Tray STORM DRAINAGE
Washing Machine 3 7j0 Size
Water Softener Material
Bar Sink To Main Drain
Comb.SinkBTray To Curb
Dental Unit
Drinking Fountain
Floor Thain WATER SYSTEM
Hopper Size
Restaurant Sink Material Sial
Sand Trap TO'T'AL FEE ,a 0
Urinal Fixture pee 'L t
Area Drain Main Drain Fee ,j OD
Water Leader Storm Thain Fee
Sprinkler Valve Water Sys.Fee ),;-0
Relief Valve Gas Fee z ' ,e t
Vac Breaker
Skimmer
Filter
/ ,0 0 Permit Fee .00
Total '1 � Total Fee i