51099.1 �a I I `i' '"L LOT NO. I
No. S
Ra ' � PLUMBING PERMIT
CI C'UPPRTINO
r o
?MAY 27 1968 sanitary ,No._
Q LL
0 Uare 3 196J
a Permit No
3
_
60 OF CUPERTI1<� Pee $
W LL
0 Application is hereby made to the Ci y 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
<w Cupertino, and all other laws applicable thereto.
F x
aLL Use of Premises _ eCP�r C_� .
00
03 Owner Address
oa
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z By �' 1�� i 5 C. Address 1W
CONT CT7. AGENT
3 ��` ;r
Phone
a �S�a� WILLIAM D. BENT CH
a o State License Approved
- U \� PLUMBING INSPECTOR
FIXTURESNUMBER
UNITS FEES UNITS FEES
Water Heate eZ 3.00 Size A/
Water Closets .00 Material C.37
Bath Tubs a 3.tr0 To Curb
Showers 3,p-p To Prop. Line .
Lavatories .p.� To Existing
Kitchen Sinks e2 3.00 Not Conn.
Dish Washers Sewer Boxes
Waste Disposals Av 'Z7, 3.Oo
\ ash Trays STORM DRAINAGE
Washing Machines o2 ,j,p-o Size
Water Softeners Material
Bar Sinks To Main Drain
Com . Sinks Trays To Curb
Dental Units
Drinking Fountains
!Te-stjurantSinks
or Drains WATER SYSTEM
ppers Size I,
Material l�•Traps TOTAL FEES
nals Fixture Fee o 7,pd
a Drains Main Drain Fee S'.Ov
ter Leaders Storm Drain Fee
nkler Valvcs Water Sys. Fee
Permit Fee ao-o
TOTAL TOTAL FEE -77770—
RECORD
3 ORECORD OF INSPECTION
Underground Rough
Partial Rough
Rough. Complex
Main Drain
Final