51087 (2) 10757 I Linda Vista Dr LOT NO. 7
NO. STE F.F.I'
JE&A TION FOR PLUMBING PERMIT
RPSEP
1� CITY' OP CUPERTINO
Sanitar Nu,
14' 1965 � ' y
e 196 Permit No. S�� 7
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wCITYkAf ati 1r 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
a w Cupertino, and all other laws applicable thereto.
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a Use of Premises -Residence
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3 OwnerFranklin-Bahl Const. AddressP•O.Box 911, Campbell
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JO By Central Service Co Tnc, Address451 Queens Lane, S. J.
CONTRACTOR, AGENT
3 m Phone 298-0556
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f State License 171537 Approved WILLIAM D. BENEVICH
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U� PLUMBING INSPECTOR v
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111XIURES NUMBER MAIN DRAIN
UNITS FEES UNITS FEES
`Plater Heate I pt, Size kf
Water Closets O o Material T
bath Tubs 10% To Curb
Showers u To Prop. Line
Lavatories o p To Existing
Kitchen Sinks e Not Conn.
Dish Washers Sewer Boxes
Waste Disposals
Wash Trays STORM DRAINAGE
Washing Machines Size
Water Softeners Material
Bar Sinks To Main Drain
Comb. Sink s Trays To Curb
Dental Units '
Drinking Fountains
floor Drains WATER SYSTEM
Hoppers Size p
Restaurant Sinks Material CpL
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TOTAL FEES
Fixture Fee , o
Main Drain Fee t+V
Storm Drain Fee
: Water Sys. FeePermit Feen: TOTAL FEE J , O
RECORD OF INSPECTION
Underground Rough
Partial Rough
Rough. Complete
Main Drain
Final .