51089.1 (11) AIS M30 I West Homestead Rd, LOT NO. Bldg, #11
NO. �� EP�k
rfMAY
CAZ&NOR PLUMBING PERMIT
C iOF CUPERTINO
xo 31 1968 , Sanitary No.
30LL -
3 a Date 52�-68 196— Permit No i
CITY Or CUPERTINO Fee $ A0 d. vr)
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o Application is hereby made to the City of Cupertino for a permit to install plumbing
o r pipes and/or fixtures listed on the reverse side hereof, and agrees to install said prices
> a 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.
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� LL Use of Premises flDflrtttlPn''G
00 801 American St .
> N
, 3 Owner Herman Christensen Address San
�� 2301 Palm Ave.
By J.W. McClenahan Co, Address a..,, 7VT., -- (,-I
O CONTRACTOR, AGENT
3 �
— w Phone
w z ,:NEVICH
a
133158 Approved
WILLL�r:i J.
of
State License
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I� —U PLUMBING INSPECTOR /
FIXTURES NUMBER MAIN DRAIN
UNITS1 FEES I UNITS FEES
Water Heater 2- Size S" 5
Water Closet 3i 8-cc Material IN
Bath Tub /6
'OU To Curb
Shower To Prop. Line �-
Lavatories 72- qYo0
I To Existing
Kitchen Sink /C Not Conn.
Dish Washer /6 A4.pU Sewer Box
Waste Disposal /6
Wash Tray STORM DRAINAGE
Washing Machine Size
Water Softener Material
Bar Sink To Main Drain
Comb.Sink&Tray To Curb
Dental Unit
Drinking Fountain
Floor Drain WATER SYSTEM
Hopper Size ;k -'4" 1 2 13.00
Restaurant Sink Material 3+t
Sand Trap r0'I'AL FEES
Urinal Fixture Fee
Area Drain Main Drain Fee ',UO
Water Leader Storm Drain Fee
Sprinkler Valve Water Sys.Fee ,CO
Relief Valve Gas Fee 2
Vac Breaker
Skimmer
Filter
Permit Fee .ry•0 0
Total Total Fee