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LION FOR PLUMBING PERMIT
za CITY OP CUPERTINO
EX ISEP 14 1965 Sanitary i1 n.
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0 j Date 2 1319
6-5 Permit No.
=CITY OFTOPERPNO ree $ 1
° 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
r and/or fixtures in accordance with the provisions of the Plumbing Code of the City of
a w Cupertino, and all other Taws applicable thereto.
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Use of Premises Residence
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r 3 Owner Franklin-Bahl Const, Address P•O.Box 9119 Campbell
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BF,ent.ral SCONervice Co. Inc. Address 451 Queens Lane, J.
TRACTOR,AGENT
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Phone 2cL-5 56
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l✓ILL:?.:.7 u. ;d-i1CH
a o State License 171537 Approved
PLUMBING INSPECTOR ,�
FIXTURES N BER MAIN DRAIN
He
NITS FEES UNITS FEES
eate ] eo Site F{ etJ
Closets -,Z Material C
bs To Curb
u To Prop. Line
ies 3 To Existing
Sinks Not Conn.
ashers Sewer Boxes
isposalsrays STORM DRAINAGE
Washing Machines tj t, 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 ( ' /7 a
Restaurant Sinks Material r,
San Traps TOTAL FEES
Urinals Fixture Fee
Area DrainsMain Drain Fee
ater Leaders Storm Drain Fee
Sprinkler Valves Water Sys. Fee /, to
Permit Fee .oa
TOTAL /00 TOTAL FEE a
RECORD OF INSPECTION
Underground Rough
Partial Rough
Rough. Complete
Main Drain
Final