51089.1 (6) P ' 21230 I West Homestead Rd. LOT NO. nl rta _ #S
NO. <rp FF1'
S 2[l T�OgIV OR PLUMBING PERMIT
I CUPERTINO
w � 3 1968 1' SanitaryNo.
x oMAY 1 'I
Oj Date 5-2�.-68 16_ Permit No
3 LL ('ITV or nt OF tn Fee $ 3S J
° Application is hereby m�adh-toTh'ey of Cupertino for a permit to install plumbing
o 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
a w Cupertino, and all other laws applicable thereto.
w Z
r
Use of Premises .Q T9 T'.}monis
00 dOl American St.
> � Herman Christensen
3 Owner Address San Ca VE-nn
of 3 1 cAve.
By J. W. McClenahan Co. Address San Mateo.Calif.
° CONTRACTOR, AGENT
3 �
— m Phone 345 16^1
w w �W144 r�;•i�'rilSills
t/ au as
State License 133158
Approved
V �PLOIuatNG'rN57'EC701tVICH /
FIXTURES NUMBER MAIN DRAIN
UNITS FEES UNITS FEES
Water Heater I I-Sv Size y' I
Water Closet N _ Material rf
Bath Tub I To Curb
Shower I To Prop. Line v
Lavatories To Existin
Kitchen Sink N Not Conn.
Dish Washer Sewer Box
Waste Disposal
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 I ty
Restaurant Sink Material 9.1
Sand Trap TOTAL FEE
Urinal Fixture Fee
Area Drain Main Drain Fee 5.00
Water Leader Storm Drain Fee
Sprinkler Valve Water Sys.Fee /. .5-0
Relief Valve Gas Fee I
Vac Breaker
Skimmer
Filter
-p Permit Fee •00
Total Total Fee