51087 (2) 10736 Linda Vista Drive 27
OT NO.
RLI T
QION FOR PLUMBING PERMIT Q
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z z I TY OF CUPF.RT[NO
x g ,SEP l 4 1965 sanitary No.
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0 a Date Sept. 13 , 196 5 Permit No.
CITY OF CUPERPNO Pee $
0 Application is hereby made to the City 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
i I 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 Rasi denee
00
, 3 0wne,Franklin-Bahl Const. AddressP.O.Box 9113 Campbell
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By Central Service Co. Inc . Address451 Queens Lane, S. J.
O CONTRACTOR, AGENT
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— � Phone 20$-0556
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a uo ' State License 171537 Approved WILLIAM D. BENEVICH
ty PLUMBING INSPECTOR (/
FIXTURES NUMBER
UNITS FEES UNITS FEES
Water Heate � d V Size p
Water Closets c Material
Bath Tubs / To Curb
Showers / To Prop. Line
Lavatories To Existing
Kitchen Sinks 1 c Not Conn.
Dish Washers Sewer Boxes
Waste Disposals
Want Trays STORM DRAINAGE
Washing Machines Size
Water Softeners Material
Bac Sinks To Main Drain
Com . Sink s Trays To Curb
Dental Units
Drinking Fountains
Floor Drains WATER SYSTEM
Hoppers Size N' e n
Restaurant Sinks Material GpL
San Traps TOTAL FEES
Urinals Fixture Fee � o O
re DDrains Main Drain Fee v
WR ater Leaders Storm Drain Fee
Sprinkler Valves Water Sys. Fee O
Permit Fee a a
TOTAL lDvt TOTAL FEE s
RECORD OF INSPECTION
Underground Rough
Partial Rough
Rough. Complete
Main Drain
Final