51167.1 (2)I�/r/ys-s.��T_Ili�?t�� LOT
NO. STREET
L FOF
Q
Ty
OF
PLUMBING PERMIT
CUPERTINO
Sanitary No.
Date V 1962 Permit No J/16 7%,/
nnt ssaBe �r Nib Fee $ C s 2 , lS-b
�j,Q� tioOF hdreb�P t City of Cupertino for a permit to install plumbing
pipc3'3n /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
Cupertino, and all other laws applicable thereto.
Use of Premises '`�/
Own /
By
CONTRACTOR, AGENT
Phone 7"�' '-�'�-3
State License ial�S�7�
_.f-2
Address
/w3
Address
A
WILLIAM D. BENF-/IGH
PLUMBING INZ!CCOR 1 /
FIXTURES j NUMBER MAIN DRAIN
UNFrSj FEES 11 UNITS
Water
To
Kitchen $ink/ Not Conn.
Dish Washer Sewer Box
Waste Disposal
Water Softener
11 Material
Bar Sink
To Main Drain
Comb.Sink & Tray
To Curb
Dental Unit
Drinking Fountain
Floor Drain
WATER SYSTEM
Hopper
Size
Restaurant Sink
Material
Sand Trap
TOTAL FEES
Urinal
Fixture Fee
Area Drain
Main Drain Fee
Water Leader
Storm Drain Fee
Sprinkler Valve
Water Sys. Fee
Relief Valve
Gas Fee
Vac Breaker
Skimmer
Filter
Permit Fee
Total 10?
f Total Fee J7J