51234 20010 Rodrigues LOT NO. 5
NO. STREET L} p
CRY of CUPEMTINO CITY OF CUPERTINO 1 r1.5
W JUN 8 AF 5gJCATION FOR PLUMBING PERMIT
x oSanitary No.
14 zA
0 � Date IMay 24 1971— Permit No S / 2-3 >6
3 `
_O Fee S 7 S�
W W
� 0 Application is hereby made to the City of Cupertino for a permit t0 install Plumbing
`o < pipes and/or fixtures listed on the reverse side hereof, and agrees to install said Prices
r 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
a Use of Premises Apartments
00
Oa Owner Jerome White Address 10159 So. Blaney
z , By, San Jose Mechanical, Inc, Address1665 Rogers Ave, S.J.
J 0
CONTRACTOR,AGENT
-3w <
275-9044m Phone
6-3-71
ao State License 26h285 Approved r�
Ul� ,\� PLUMBING INSPECTOR
FIXTURES NUMBER MAIN DRAIN
Units Fees Units Fees
Water Heater /S0 size y" S.0,0
Water Closet L .ob Material C i
Bath Tub G 1ov To Curb
Shower To Prop. Line
Lavatories L loo To Existing
Kitchen Sink 9,en Not Conn.
Dish Washer
Waste Disposal
Wash Tray STORM DRAINAGE
Washin Machine Size
Water Softener Material
Bar Sink To Main Drain
Comb.Sink&Tray To Curb
Dental Unit
Drinking Fountain
Floor Drain WATER SYSTEM
Hopper Size l�a
Restaurant Sink Material ��✓
Sand Trap TOTAL FEES
Urinal Fixture Fee -37.56
Area Drain Main Drain Fee Sen
Water Leader Storm Drain Fee
Sprinkler System Water Sys. Fee .J
Refief Valve I Gas Fee
/•5D
Vac Breaker
Skimmer
Filter
Pool Sweeper
Permit Fee ?.00
Total 3-S Total Fee ,S