51046 (2) 10706 Rosewood
LOT NO.
NO. STREET
APPLICATION FOR PLUMBING PERMIT
y a CITY OP CUPERTINOF
�[Q _
0 a Date 9 Permit No
3 /MAY 25 1967 1 } Fee ��5=
� LL
0 Application is hereby made to the i y of Cupertino for a permit to install plumbing
o rpipes and/or fixtures listed on the reverse side hereof, and agrees to install said prices
> and or fwt`V� i fccco{{�� QQ�88 k1nn!``�revisions of the PlumbingCode of the City of
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Cupertino,I and aKtheY�lemwllt�Slh thereto. }
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LL Use of Premises 4-P1eX
00
1- 3 Owner William White Address 365 La Prenda Way
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J i By Winchester Plumbing Co. Address 1217 Dell Ave.
e CONTRACTOR, AGENT
3 �
N Phone 378-7615
a
-
. z
a o State License C 210245 Approved gyoox
_U �l
1 PLUMBING INSPECCOR
—__ 1 .
FIXTURES NUNIB17R MAIN
UNITS FEES UNITS FEES
Water Heater Size
Water Closets Material
Bath Tubs To Curb
Showers To Prop. Line
Lavatories ,Z To Existing
Kitchen Sinks Not Conn.
Dish Washers Sewer Boxes
Waste Disposals '
Wash Trays STORM DRAINAGE
Washing Machines Size
Water Softeners Material
Bar Sinks To Main Drain
Comb. Sink s Trays To Curb
Dental Units
Drinking Fountains
r--lour Drains WATER SYSTEM'
Hoppers Size - un
Restaurant Sinks Material ^ *—vr
San Traps TOTAL FEES
Urinals Fixture Fee
Area Drains Main Drain Fee
Water Leaders Drain Fee av
Sprinkler Valves Water Sys. Fee
Permit Fee D
TOTAL 6 TOTAL FEE &V S-0
RECORD OF INSPECTION
Underground Rough...
.Partial Rough..
.Rough. Complete_
\Iain Drain
Final...