51089.1 (12) gill 21230 ( West Homestead ltd. IAT NO. Sl_rlo. 419 `
NO. STPEri'
A C N.FOR PLUMBING PERMIT
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w F CUPERTINO
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s o '� Sanitary No.
LL (N1�Y8 31 1968 ; ,� Y
o J Date 195— Permit No .S /
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U S� S�
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° Appli lTion of Cupertino for a permit to install plumbing
o rw- pipes and/or fixtures listed on the reverse side hereof, and agrees to install said prices
> I and/or fixtures in accordance with the provisions of the Plumbing Code of the City of
<w Cupertino, and all other laws applicable thereto.
' W S
j LL Use of Premises apartments _
00 oul timerican Wit.
> 3 owner Herman Christensen Address San Carlos
°j 2301 Palm Ave.
J , g J. FJ, McClenahan Co. Address 14.--
O y CONTRACTOR, AGENT
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Phone 345-1691
– z
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f State License 133158
Approved
WILLIAM D. BENEVICH.
a o PP
—U y PLUMBING INSPECTOR /
FIXTURES NUMBER MAIN DRAIN
UNITS FEES UNITS FEES
-Water-Hester I 1. o Size It I -S•bp
Water Closet 8 .00 Material 9r1
Bath Tub B ,co To Curb
Shower To Pro . Line rr
Lavatories S /I-,(:Ce To Existing
Kitchen Sink 12,00 Not Conn.
Dish Washer Sewer Box
Waste Disposal _
Wash Tray STORM DRAINAGE
Washing Machine Size
Water Softener Material
Bar Sink pMaterial ,�.j
Comb.Sink&Tray
Dental Unit
DrinkingFountain
Floor Drain
Hopper I , 'p
Restaurant Sink Sand Trap E
Urinal Fixture Fee
Area DrainMain Drain Fee !�.,00
Water Leader Storm Drain Fee
Sprinkler Valve Water Sys.Fee
Relief Valve Gas Fee / 1.5-D
Vac Breaker
Skimmer
Filter
17—n Permit Fee -U 0
Total Total Fee 9,y"o