51046 /'f c/ I ��~ WAAO 0 _ LOT NO.
NO. SIAEE.I'
C` Mry,
OR PLUMBING PERMIT
W .i �&CIOF CUPERTINO
z -
/NOV /1� 1967 sanitary ���n.
LL _
0 a Date 196 Permit No. _� i 5<-1 C-
Fee $
° A >li'lYn Fs'herel>)��InpaER IP41ity 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
> 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.
,. Use of Premises
00
> " JA16I(' l��/rC'/fL�r /0&/19.0
0 3 Owner Address
By RAYNE SOFT WATER STI'Lres5
J O y CONTRA 'OR• AGENT'-
a SANTA CLAM, CALIFORNIA 95050
- a Phone
w z PHONE 241-7E/
aWILLIAD. GENKWICH ;
a o State License.a �y`�s� WILLIAM
-U PLUMBING INSPECIOA /
�c.
FIXTURES NUMBER 11 MAIN DRAIN
UNITS1 FEES 11 UNITS FEES
Water Heater I Size
Water Closet Material
Bath Tub To Curb
Shower To Prop. Line
Lavatories To Existing
Kitchen Sink Not Conn.
Dish Washer Sewer Box
Waste Disposal
Wash Tray STORM DRAINAGE
Washing Machine Size
Water Softener Material
Bar Sink To Main Drain
Comb.Sink&Tray To Curb
Dental Unit
Drinking Fountain
Floor Drain WATER SYSTEM
Hopper Size
Restaurant Sink Material
Sand Trap TOTAL FEES
Urinal Fixture Fee
Area Drain Main Drain Fee
Water Leader Stom Drain Fee
Sprinkler Valve Water Sys.Fee
Relief Valve Gas Fee
Vac Breaker
Skimmer
Filter
Permit Fee
Total Total Fee