51089.1 (5) 1
21230 West Homestead Hd. LOT NO. SEE
NO. STREET'
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ATro FOR PLUMBING PERMIT
44��IT ( rCUPI:RTINO
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r ° /�Y 31 1968 I Sanitary No.
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3 a Date 5-24— 8 96- Permit No o if9.i
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° App�laiio is�h�reb�4ira�delt(�rthe�fty 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
> 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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n Use of Premises apartments
90 801 American St.
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Owner Herr1an Chr'_sten Ser Address San
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�_j 2301 Palm Ave.
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[ By J . W . Mrel anaA an ('... Address e..., i�T-.+__ CE _
CONTRACTOR, AGENT ..,�
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— wPhone
w w 45-1071 WILLIAM D. BENEVICH
s State License 1 1'31 519 Approved
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PLUMBING INSPECTOR ,
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FIXTURES NUMBER MAIN DRAIN
UNITS FEES UNITS FEES
Water Floater Size Y- —
Water Closet 4 E'— Material ,921I
Bath Tub 4 To Curb
Shower To Prop. Line
Lavatories t/ To Existing
Kitchen Sink Y Not Conn.
Dish Washer Sewer Box
Waste Disposal
Wash Tray STORM DRAINAGE
Washing Machine 3 150 Size
Water Softener Material
Bar Sink To Main Drain
Comb.Sink&Tray To Curb
Dental Unit
Drinking Fountain
Floor Drain WA'T'ER SYSTEM
Hopper Size I'Y" I /,���
Restaurant Sink Material ,9a
Sand Trap TOTAL FEES
Urinal Fixture Fee ,SD
Area Drain Main Drain Fee •00
Water Leader Storm Drain Fee
Sprinkler Valve Water Sys.Fee j,y o
Relief Valve Gas Fee
Vac Breaker
Skimmer
Filter
/..1 0 Permit Fee ,CO
Total
Total Fee ,�0