NO PERMIT NUMBER (3) /d �z I ""' '^"'-`-'mow _ LOT NO. _
NO. STREET
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- APPLICATION FOR PLUMBING PERMIT
moi;
ICITY OF CUPERTINO
r ?PNOV 2 8 1966 ; Sanitary No.
LL
o a Date November 17 I966 Permit No
LLCITY OF CLlPOTINO Fee $
O Application Is here y 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
H 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 I
w Use of Premises Household
o0
7 N
3 Owner E. J. CONENS Address 10480 PINEVILLE AVE.
oa
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J By SOFTMASTER, INC. Address 1150 DELL AVE.CAMPBELL
20 CONTRACTOR,AGENT
3 F
- m Phon 379-9050
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¢ a
u s State License Approved /
a o. K"
C�yI�X, PLIIMBING INSPECTOR ' /
FIX-1
UNITS FEES UNITS FEES
Water Heate 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 � .may Material
Bar Sinks To Main Drain
Com . Sinks Trays To Curb
Dental Units
Drinking Fountains
Floor Drains WATER SYSTEM
Hoppers Size
Restaurant Sinks Material
San Traps TOTAL FEES
Urinals Fixture Fee'
Area Drains Main Drain Fee
-ater Leaders Storm Drain Fee
Sprinkler Valves Water Sys. Fee
Permit Fee
TOTAL TOTAL FEE 3, d
RECORD OF INSPECTION
Underground Rough...
Partial Rough..
Rough. Complete..
Main Drain
Final_.