51087 (2) LOT NO. 21 _
® APPS �11'190N FOR PLUMBING PERMIT
w t fSEP 14 1965 CITY OF CUPERTINO
�oy q Sanitary iNo.
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196 ,5 Permit No 4 ,/ O k 7
55U
i n Fee S
o 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
i m 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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LL Use of Premises Residence
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7 N
oa Owner Franklin—Bahl Const. AddressP n BQX c1TiT6+� P�„11
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By Central Service Co. Inc, Address451 Queens Lane, S J.
O CONTRACTOR, AGENT
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— `m Phone 298-0556
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a oI State License— I 74:�q7 Approved WILL IAf.7 D. =�IRSti(CH
U PLUMBING INSPECTOR `
—TIXURES NUTN BER MAIN DRAIN
UNITS FEES UNITS FEES
Warer Heate 0o Size ,L b
Water Closets oa Material C
Hath 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
Com . Sink s Trays To Curb
Dental Units
Drinking Fountains
Floor Drains WATER SYSTEM
Hoppers Size I e
Restaurant Sinks Material (y
San Traps TOTAL FEES
Urinals Fixture Fee
Area Drains Main Drain Fee
Water Leaders Storm Drain Fee
Jprinklcr Valves Water Sys. Fee )^:D 0
Permit Fee
TOTAL TOTAL FEE p
RECORD OF INSPECTION
Underground Rough
Partial Rough
Rough. Complete
Main Drain
Final .