51087 (2) 107 azDrive LOT NO. 29
,a
® P ION FOR PLUMBING PERMIT
BSEP 14 t965 CITY ON CUPERTINO
r o - Sanitary No,
to 196 . Permit No d"
I � -bu
o Application is hereby made to the 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
and/or fixtures in accordance with the provisions of the Plumbing Code of the City of
Z N )
a w Cupertino, and all other laws applicable thereto.
w x
� r
.. Use of Premises Residence
00
Oa Owner Franklin-Bahl Const. AddressP.O.Box 9110 Campbell
O <
o By Central Service Co InC AddressL51 Q I .Pns Lane , S,J,
F CONTRACTOR, AGENT
- < Phone 29$-0556
wz
ww
uf State License Approved WILLIAM D. BENEVICH O 17}�}�
PLUMBING INSPECTOR �/
111X I URhSNUMBER
UNITS FEES UNITS FEES
Water Hcatc ( oo Size LI- n Cp
Water Closets Z 7 , o Material (�
Bath Tubs au To Curb
Showers y p To Prop. Line
Lavatories 4 u To Existing
Kitchen Sinks a Not Conn.
Dish Washers Sewer Boxes
Waste Disposals
Wash Trays STORM DRAINAGE
Washing Machines r ac Size
Water Softeners Material
Bar Sinks To Main Drain
Com . Sink--, Trays To Curb
Dental Units
Drinking Fountains
Floor Drains WATER SYSTEM
Hoppers Size I( e�
Restaurant Sinks Material GwL
San Traps TOTAL FEES
Urinals Fixture Fee D-"
Area Drains Main Drain Fee 1 p i4
Water Leaders Storm Drain Fee ._
Jprinklcr ValVes Water Sys. Fee a O
Permit Fee x p p
TOTAL TOTAL FEE /
RECORD OF INSPECTION
Underground Rough
Partial Rough
Rough. Complete
Main Drain
Final