51131 10751 I MARTINWOOD WAY LOT NO.
NO. STREF.I'
66�� t^J„Ch IIV;kkF)OR PLUMBING PERMIT
P CUPERTINO
x o Sanitary No.
� 4 11
o Uate MApril 30 196-8Permit No S// 3 /
3 <
Pee $ .50
' 0 AppliIa ion Pity of Cupertino for a permit to install plumbing
Oa pipes and/or fixtures listed on the �eversc 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.
Wx
W Use of Premises HOUSEHOLD
00
3 Owner HAROLD E. R=ZIER Address 10751 MARTINWOOD WAY
0a
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J c By SOFTHASTER, Inc. Address P.O. Box 496
O CONTRACTOR, AGENT
3 �
— m` Phone 3791/5050
W Z
W W * 234281 5.. :. •.
a .._..��......
< 0 State License Approved
—U,1 PLUMBING INSPECTOR
FC1—
FIX I UREbJIBER MAIN DRAIN
UNITS FEES UNITS FEES
Water Hcate Size
Water Closets Material
Bath 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
Comb. Sink & Trays To Curb
Dental Units
Drinking Fountains
floor Drains WATER SYSTEM
Hoppers- Size
Restaurant Sinks Material
San Traps TOTAL FEES
Urinals Fixture Fee / o
Arca Drains Main Drain Fee
Nater Leaders Storm Drain Fee
�prinklrr Valves Water Sys. Fee
Permit Fee
TOTAL T SAL FEE
REC(!54 OFHfN ON
_Underground Rough ;yaI(
Partial Rough ffl 1"k
Rough. Complete
Main Drain
Final .