51087 220 da Vista Place LOT NO. 17
N F.
?SEP
C ON FOR PLUMBING PERMIT
CITY OP CUPERTINO
f 1. 4 1965
n 0 Sanitary iN o.
-
0 , I)ate 1965 Permit No
3 LL CIT D'
w Fee 3 /_l;u--
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� Application is hereby made to the Cit} 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
r 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 RPRICyPnr1P
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oO < n.% ,911 C� tgbell
3 Owner_Franklin—Bahl Gnn St _ Address P. (}_R l
J , By Central Service Co. Inc.Address 451 Queens Lane; J.
O CONTRACTOR, AGENL
3 �
- w Phone 29656
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a o State License 1 71537 Approved WILLIAM D. 8^eNEVICH J /
- U PLUMBING INSPECTOR
FIXTURES MMAIN DRAIN
UNITS FEES UNITS FEES
Water Heate Op Size /t, Z,—bt;
Water Closets Material C
Hath Tubs 1, 00ms• To Curb
Showers C J To Prop. Line
Lavatories To Existing
Kitchen Sinks Not Conn.
Dish Washers Sewer Boxes
Waste Disposals
Wash Trays STORM DRAINAGE
Washing Machines I fO 0 Size
Water Softeners Material
fflSnkks To Main Drain
Sink s Trays To Curb
Units
g Fountains AOLrainsWATER SYSTEM
s Size / " Q12
ant Sinks Materialraps TOTAL FEES
Fixture Fee CO
4,,Irains Main Drain Fee
W ater Leaders Storm Drain Fee —
Spnnkler Valves Water Sys. Fee 0, 01
Permit Fee 7-C(9
TOTAL TOTAL FEE �d
RECORD OF INSPECTION
Underground Rough
Partial Rough
Rough. Complete
;Hain Drain
Final