51127 LOT NO.
NOi5 a
D I FOR PLUMBING PERMIT
d Y OF CUPERTINO
ra AUG 13 1965 Sanitary No.
RLL j//?7
o a Date 196— Permit No
LL CITY UF CUPERTINO Pee
O Application is heieby made to the City of Cupertino 174 a permit to install plumbing
o a pipes and/or fixtures listed on the reverse side hereof, and agrees to install said prices
and/or fixtures in accordance with the provisions of the Plumbing Code of the City of
<w Cupertino, and all other laws applicable thereto.
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r Use of Premises dwe 1 1 Ing
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> N
� 3 OwherWarren Pugh Address 22474 Starling Ct.
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J By Softmeater Address1150 Dell Ave_ Cn...p6a]1
O CONTRACTOR, AGENT
– a , Phone
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State License.oT ���/ -Approved
I
FIXTURES NUD E IN DRAIN
UNITS FEES UNITS FEES
Water Heater $ize
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
\hater Softeners Material
Bar Sinks To Main Drain
Comb. Sink w Trays To Curb
Dental Units
Drinking Fountains Amok
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 Fm
�prinklrr Voives Water Sys. Fee
Permit Fee _:2
TOTAL / TOTAL FEE
RECORD OF INSPECTION
Underground Rough...
.Partial Rough..
.Rough. Complete..
\Iain Drain
Final...