51087 Rriari
221 `�, LOT NO. 37
® APPL C�1'�TI'ON FOR PLUMBING PERMIT
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tSEP 14 1965 CITY OF CUPGRTINO
r o Sanitary No.
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3 u CI I f f ,., 19G Pamir No.
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m 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
a w Cupertino, and all other laws applicable thereto.
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Use of Premises Residence
00
, 3 Owner Franklin—Bahl Cnnst._ AddressP_fl_Rnx Q11 � f'.amhell
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JZ By Central Service Co. Inc-yddre,,451 Queens Lane, S.J.
O CONTRACTOR, AGENT
3N Phone 298-0556
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a o State License 1715 Approved WILLIAM D. BENEVICH
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// PLUMBING INSPECTOR V
FIXTURES 1
UNITS FEES LMTSSLFEES
Water Heave u v Size F/ t
Water Closets oo Material
Bath Tubs / To Curb
Showers 0 r 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 Trays To Curb
Dental Units
Drinking Fountains
Floor Drains WATER SYSTEM
Hoppers Size /" / VV
Restaurant Sinks Material
San Traps TOTAL FEES
Urinals Fixture Fee 10, 00
Arca Drains Main Drain Fee e O
/ater Leaders Storm Drain Fee
Sprinkler Valves Water Sys. Fee O
Permit Fee p O
TOTAL Ir C)Q4 11 TOTAL FEE 0 d
RECORD OF INSPECTION
Underground Rough
Partial Rough
Rough. Complete
Main Drain
Final