51145 (2) / `-' "`""' „`« LOT NO.
No . �j
5A PE�#L-�4It FOR PLUMBING PERMIT
a I Y OF CUPLRTINO
f � ?UL J.4 1966
r o Sanitary \o.
tt a
3 aDate l,, l , 196— Permit No " vs—
CITY CITY OF i!P RTINO Fee $
0 Application is hereby madeto 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
I 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.
w x
Use of Premises Installation of Soft Water Unit
00
p 3 Owner�ulliaan Soft Water Address 611 University Ave.
�� Los Gatos , Calif.
J , By Phomas S. Kennedy Address �Cll University L,G.
o
CONTRACTOR, AGENT
3Phone \/354-1845
—
w z
¢ a /P /
a o State License C55 Approved
_U PLUMBING INSPECTOR
FIXTURES n
UNITS FEES UNITS FEES
Water Heatc Size
Water Closets Material
Fath Tubs To Curb
Showers To Prop. Line
Lavatories To Existing
Kitchen Sinks Not Conn.
Dish Washers Sewer Boxes
Waste Disposals
Wasp Trays STORM DRAINAGE
Washing Machines Size
Water Softeners Material
Far Sinks To Main Drain
Com . Sink s Trays To Curb
Dental Units
Drinking Fountains Ad
Floor Drains WATER SYSTEM
Hoppers Size
Restaurant Sinks Material
San Traps TOTAL FEES
Urinals Fixture Fee
Area Drains Main Drain Fee
Water Leaders Storm Drain Fee
�prinkler valves Water Sys. Fee
Permit Fee
TOTAL TOTAL FEE
RECORD OF INSPECTION
Underground Rough
Partial Rough
Rough. Complete
Main Drain
Final