51099.1 aa�a 17t�r� s� LOT NO. a0
NO. ST EEI'
' TTI R PLUMBING PERMIT
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AY 2 1968 S:mitary No.
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o I)at e �2 19 �� Permit No
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Application a hereby I c t+ h r f Cupertino for a permit to msLll Plumbing
o a 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.
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Use of Premises
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oa Owner Address eras 2d . .�1AV 41
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CON (-TOR, AGr.NT
3 36— /W—
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w z WILLIAM D. SENEVICH
ao State License Approved
PLUMBING jNSPECTOR
FIXTURES MMAIN L)RAIN
UNITS FEES UNITS FEES
Water Heate .2 .3,0"0 Size
Water Closets ..f 6.tm Material G.
Bath Tubs 2 3,ero To Curb
Showers y 3.00 To Prop. Line„
Lavatories ,p-0 To Existing
Kitchen Sinks 3,00 Not Conn.
Dish Washers Sewer Box"
Waste Disposals k,Z I 3.00
Wafh Trays STORM DRAINAGE
Washing Machines y loo 1 Size
Water Softeners Material
Bar Sinks To Main Drain
Comb. Sink m Trays To Curb
Dental Units
Drinking Fountains
Floor Drains WATER SYSTEM
Hoppers Size /" TTV
Restaurant Sinks Material rp,ylv
San Traps TOTAL FEES
rinals Fixture Fee 0'700
rea Drains MainDrain Fee j.Do
Water Leaders Storm Drain Fee
Sprinkler Valves Water Sys. Fee r Sv
Permit Fee ,Oct
TOTAL TOTAL FEE 3 U
RECORD OF INSPECTION
Underground Rough
Partial Rough
Rough. Complete
Main Drain
Final