51145 2/ S 1 J �_T DQE T NO.
NO. SnEE-r
ON FOR PLUMBING PERMIT
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w 0 Sanitary No.
0o Uaze/JULJu�� 16 196 6 Permit No
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° >h n e6yillpl � the Cit}' of Cupertino for a permit n install plumbing
0 a pipes and/or fixtures listed on the reverse side hereof, and agrees to install said prices
r 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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w Use of Premises HOUSEHOLD _ INSTALLER
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3 Owner RffiHARD PHELPS Address 21593 1-4 PLAYA CT.
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J � By SOFTMASTER, INC. Address 1150 DELL AVE. CAMPBELL
° CONTRACTOR, AGENT
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- am Phone 8 379-5050
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oState License 234281 Approved %%PIT r IAR.I n Rr-nlryf
U PLUMBING INSPECTOR
FIX I URES NUMBER
UNITS FEES UNITS FEES
Water Heate Size
Water Closets Material
bath Tubs To Curb
Showers To Prop. Line
Lavatories To Existing
Kitchen Sinks Not Conn.
Dish Washers Sewer Boxes
Waste Disposals
\Was Trays STORM DRAINAGE
Washing Machines Size
Water Softeners Material
Bar Sinks To Main Drain
Comb. Sink u Trays To Curb
Dental Units
Drinking Fountains
Floor Drains WATER SYSTEM
Hoppers Size
Restaurant Sinks Material
Sand Traps TOTAL FEES
Urinals Fixture Fee
Area Drains Main Drain Fee
Water Leaders Storm Drain Fee /. W
Sprinkler Volvcs WaSys. Fee 2 �y
Permterit Feed
TOTAL TOTAL FEE
RECORD OF INSPECTION
Underground Rough
Partial Rough
Rough. Complete
.lain Drain
Final