51039 i
t0t91 PHARLAP DRIVE LOT NO.
NO. STREEI'
WPPL-I�TION�FOR PLUMBING PERMIT
Z < G �r OP CUPERTINO
r 0 JAN 4 1965 f�J Sanitary No.
W
3963Uate DEC 14 963- Permit No S�O �—/
_" CITY OF QPERTI, � Fee $ �-
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° Application is here y made to t to 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 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.
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Use of Premises DWELLING
0 0
oa Owner GEORGE B. BRUCE Address 10321 PHARLAP DRIVE
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z By SOFTMASTER, INC. Address 1150 DELL, CAMPBELL
° CONTRACTOR,AGENT
3 �
— Phone 174_50SO
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ao State License 234281 Approved W� _
U!J PLUMBING INSPECTOR
IX-1 URFS NUMBER
UNITS FEES UNITS FEES
Water HMb
Size
Water Material
Bath TuTo Curb
ShowersTo Prop. Line
LavatoriTo Existing
KitchenNot Conn.
Dish Washers Sewer Boxes
Waste Disposals
Wash Trays STORM DRAINAGE
Washing Machines Size
Water Softeners ' 1 Material
Bar Sinks To Main Drain
Com . Sinks Trays To Curb
Dental Units
D nri king Fountains
Floor Drains WATER SYSTEM
Hoppers Size
Restaurant Sinks Material
San Traps TOTAL FEES
Urinals Fixture Fee 1.00
rea Drains Main Drain Fee
Nater Leaders Storm Drain Fee
Sprinkler Vd,,s Water Sys. Fee
Permit Fee 2.00
TOTAL TOTAL FEE 3.00
RECORD OF INSPECTION
Underground Rough
Partial Rnugh
Rough Complete
:Hain Drain
Final