NO PERMIT NUMBER ft5q I Q , LOT NO. 153
NO. STREET
APPLICATION FOR PLUMBING PERMIT
z i d CITY OF CUPERTINO
rSanitary No.
¢ 0
0 'a Date 196 Permit No
3
u
wa
Fee $ r--- - -I �
T o
Application is hereby made to the City of up for a permit to install plumbing
`o pipes and/or fixtures listed on the ever he o atqYt!Mrees to install said prices
iN and/or fixtures in accordance a t e � ng Code of the City of
< w Cupertino, and all other laws g ab e thereto.
a Use of Premises
f SEP 19 1968
00
> w It biv p s 151 a
OJ By riefnirl law , 9r'`
OAGENT g (Char es
— 0 Phone CONTR�ZSan Jose, California 95112
w z
aState License 17J3 7 Approved _
w w �
¢ a
O �
—V PLUMBING INSPECTOR
L,JVFIXTURES NUMBER I MAIN DRAIN
UNITS FEES I UNITS FEES
Water Heater Size 441,
Water Closet 0 Material C4.47'
Bath Tub / L02 To Curb
Shower ,Lp To Prop. Line
Lavatories 6,00 To Existing
Kitchen ink ; p Not Conn.
Dish Washer Sewer Box
Waste Disposal
Wash Tra STORM DRAINAGE
Washing Machine Size
Water Softener Material
Bar Sink To Mai ain
Comb.Sink&Tray urb
Dental Unit
Drinkin Fountain
Floor Drain WATER SYSTEM
Hopper Size /"
Restaurant Sink Materia A,tZ
Sand Trap TOTAL FEES
Urinal Fixture Fee Q
Area Drain Main Drain Fee S(b
Water Leader Storm Thain Fee
Sprinkler Valve Water Sys.Fee (.J
Relief Valve Cas Fee
Vac Breaker
Skimmer
Filter
Permit Fee OU
Total Sp Total Fee