51145 / a � LOT NO.
NO. STREEl
IWION FOR PLUMBING PERMIT
Z Z �yOF CUPERTINO
a O 1�JUN Sanitary No,
0 a Uate 1 0 196 6_ Permit No S�
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W LL Fees 3 `
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QITcytio h"P fA jtppQ��y City of Cupertino for a permit to install plumbing
'o a pipes and/or�tixtur s I thiI li A�t aleverse side hereof, and agrees to install said prices
rand/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 HOUSEHOLD _ HOOK UP (INSTALLED)
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' " CHARLES M. HOWELL 21536 MONROVIA STREET
0 3 Owner Address
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Z` By SOFTMASTER, INC. Address 1150 DELL AVENUE, CAMPBELL
O CONTRACTOR,AGENT
3 �
— m Phone 379_5050 (408)
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a `o State License 234281 Approved IC/ AJJLf[,
U PLUMBING INSPECTOR /
FIXTURES F--NlJYMn7T— MAIN DRAIN
UNITS FEES UNITSI FEES
Water Hcate Size
Water Closcts Material
Hath Tubs To Curb
Showers To Prop. Line
Lavatories To Existing
Kitchen Sinks Not Conn.
Dish Washers Sewer Boxes
Waste Disposals
Was-Trays STORM DRAINAGE
Washing Machines Size
Water Softeners Material
Bar Sinks To Main Drain
Com . Sink & Trays To Curb
Dental Units
Drinking Fountains
Moor Drains WATER SYSTEM
Hoppers Size
Restaurant Sinks Material
Sand Traps TOTAL FEES
Urinals Fixture Fee j, c O
Area Drains Main Drain Fee
Water Leaders Storm Drain Fee
`prinklcr VatvcsWater Sys. Fee
Permit Feey, O o
TOTAL TOTAL FEE 3.00
11 . ,rt RECORD OF INSPECTION
Underground Rough
Partial Rough
Rough Complete
Alain Drain
Final