51037 11126 I Linda Vista Dr. LOT NO.
NO. STREET
APPLICATION FOR PLUMBING PERMIT
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CITY OF CUPERTINO
r o Sanitary N0.
40
a Date L 196r Wewwit No
wU Fee $
= LL
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
> and/0r 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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LL Use of Premises Residence
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3 Owner C. Sordal Address 11126 Linda Vista Dr.
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jz By COAST WATER SOFTENER CO. Address 807 THE AL AMEDA
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r CONTRACTOR,AGENT
3
— 0 Phone
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a o State License /-I-3V0- Approve
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-0 PLUMBING INSPECTOR
FIXTURES NUIN BER MAIN DRAIN
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
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
Restaurant Sinks Material
-Sin'J Traps TOTAL FEES
Urinals Fixture Fee
r'e-Drains Main Drain Fee
Water Leaders Storm Drain Fee
Water S s. Fee
Sprinkler Valves y
Permit Fee
TOTAL TOTALFEE
RECORD OF INSPECTION
Underground Rough...
Partial Rough..
Rough. Complete..
Slain Drain
Final....