51114 (3) I9 • 1 6
NO. SnEET
APPLICATION FOR PLUMBING PERMIT
z < CITY OF CUPERTINO
i
xo Sanitary No.
3 < Date November 10. 1964 , 196— Permit No
w a Fee $
4.00
so
� Application is hereby made to the City of Cupertino for a permit to install plumbing
'oa 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
a W Cupertino, and all other laws applicable thereto.
w I
a Use of Premises
HOUSEHOLD
20
> ; Owner P. R. Musearello Address 19726 Whnaenn Dr-
o <
zJ
z By SOFTMASTER, INC. Address 807 The Alameda
�
O COiZAOA, AGENT
3 � I
- Phone 295-3435
w z
ao State License Z -3 U'o3 Approved
U PLUMBING INSPECTOR
FIXTURES
UNITS FEES UNITS FEES
`mater Heate Size
Water Closets Material
Bath Tubs To Curb
Showers To Prop. Line
Lavatories To Existing
Kitchen Sinks Not Conn.
Dish Washers 11 Sewer Boxes
Waste Disposals
Wash Trays STORM DRAINAGE
Washing Machines Size
Water Softeners 1,2,% Material
Bar Sinks To Main Drain
Comb. Sink s Trays To Curb
Dental Units
Drinking Fountains
F=loor Drains WATER SYSTEM
Hoppers Size
Restaurant Sinks Material
San Traps TOTAL FEES
Urinals Fixture Fee G G
Area Drains Main Drain Fee
Y/�� ater Leaders Storm Drain Fee
Sprinkler Valves Water Sys. Fee G G'
Permit Fee �, p
TOTAL TOTAL FEE , r(i
RECORD OF INSPECTION
Underground Rough...
Partial Rough..
Rough. Complete..
Main Drain
Final...