51087 (3) 221 � .4..Lnrin IN -ta_Ejace LOT NO. 22
® S EP ). 4 1965 A P 1 ION FOR PLUMBING PERMIT
a CITY OF CUPERTINO
w � �
x o Sanitary No.
0LL � /ok7
3 6^I}-aEe 196 Permit No.
_ I T Pee S
0 Application is hereby made 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
wCupertino, and all other laws applicable thereto.
w i
LL Use of Premises Residence
0 0
3 Owner Frankl Const Address P. O.Box 9110 Campbell
0 a
zJ
JO By Central Service Co. Inc. Address 451 Queens Lane, S, J.
3 r CONTRACTOR, AGENT
— M Phone 298-0556
w z
WILLI1,:J D. L_N_VICH
< 0 State License----J-71 q'? Approved
U PLUMBING INSPECTOR
HX I URESNUMBER
UNITS FEES UNITS FEES
Water Hearc 1,O Size 4r Z 0
Water Closets Material C�
Bath Tubs no
0„ To Curb
Showers / _ To Prop. Line
Lavatories Z 1,0 To Existing
Kitchen Sinks / �d Not Conn.
Dish Washers Sewer Boxes
Waste Disposals
Wash Trays STORM DRAINAGE
Washing Machines f [od Size
Water Softeners Material
Bar Sinks To Main Drain
Com . Sink s Trays To Curb
Dental Units
Drinking Fountains
Floor Drains WATER SYSTEM
Hoppers Size I "
Restaurant Sinks Material Gy
Sa�'raps TOTAL FEES
Urinals Fixture Fee / o. b U
Area Drains Main Drain Fee e
Water Lenders Storm Drain Fee
Jprinklcr Valves Water Sys. Fee / 0
Permit Fee Z G t
TOTAL TOTAL FEE s Oo
RECORD OF INSPECTION
Underground Rough
Partial Rough
Bough. Complete
%lain Drain
Final