51145 K. 'e/ I W LOT NO.
NO. STREP. -
pWPLITAjTIqN FOR PLUMBING PERMIT
Y o �
OF CUP[iRTINOY
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Samrir No. i
o ] Date � 1966 r96Permit No.
a
w LL Pee $ 1;20
A&i IF1)f io9'q hf5 , 1�,"TbfQ City, of Cupertino for a permit t tall plumbing
o a pipes and/or Ixtures lisle 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
a w Cupertino, and all other laws applicable thereto.
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� r
a Use of Premises
00 J LL
3 0VMC Address
o j P. O. Box 802 CHOVJW PLUMBING Co. INC.
� z By Address P. O. Box BR9
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Saratoga. California
— m Phone C
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a a ® �a o State License Approved /
PLUMBING INSPECTOR �/
FIXTURES NIJM
UNITS FEES UNITS FEES
Water Heate Size
Water Closets ,j' Materi
Bath Tubs To Curb
Showers To Prop. Line
Lavatories 3 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
Moor Drains WATER SYSTEM
Hoppers Size
Restaurant Sinks Material ,,aG
San Traps TOTAL FEES
Urinals Fixture Fee
Arca DrainsMain Drain Fee 0,0
Water Leaders Storm Drain Fee
Jprinkier V:,Ivcs Water Sys. Fee D
Permit Fee
TOTAL TOTAL FEE
RECORD OF INSPECTION
Underground Rough
Partial Rough
Rough. Complete
Main Drain
Final