51087 1071-7 I Linda Vista Dr. LOT NO. 6
NO. STI EEI'
APPLICATION FOR PLUMBING PERMIT
Zi j&13� CITY OF CUPF.RTINO
, 0 ® j� Sanitary iNu.
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01 1 at , 1965 Permit No,
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Application is hereb• made to the City of Cupertino for a permit to install plumbing
`o qtTI aI F)r WRf f liaothe reverse side hereof, and agrees to install said prices
> d or �xhlres m actor ante 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 ReGidence
3 Owner Franklin-Bahl Const. Address— ' P
> 0 P.O.Box 911 Campbell
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;z ByCentral Service Co. Inc. Addres.451 Queens Lane , S.J.
O CONTRACTOR, AGENT
3
- Phone 298-0556
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s State Licenser- I� Approved WILLIAM D. I3ENEVICH
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U PLUMBING INSPECTOR
FIXTum-.b NUMBLIt MAIN DRAIN
UNITS FEES UNITS FEES
Water Heate fCU Sizek
Water Closets cc Material G
bath Tubs ) CO To Curb
Showers l C p To Prop. Line
Lavatories 3.eu To Existing
Kitchen Sinks I Not Conn.
Dish Washers Sewer Boxes
Waste Disposals
Wash Trays STORM DRAINAGE
Washing Machines LOU Size
Water Softeners Material
Bar Sinks To Main Drain
Comb. Sink s Trays To Curb
Dental Units
9-Traps
g Fountains
rains WATER SYSTEM
s Size I C
nt Sinks Material �j
aps TOTAL FEES
Fixture Fee
rainsMain Drain Fee ? U
eaders Storm Drain Fee
r Valves Water Sys. Fee !, 0 V
Permit Fee 7,o l
TOTAL o c TOTAL FEE , Q
RECORD OF INSPECTION
Underground Rough
Partial Rough
Rough. Complete
Main Drain
Final