51122 (2) 10425 I Tonita Tanv LOT NO.
No. STREET
APPLICATION FOR PLUMBING PERMIT
d CITY OF CUPERTINO
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Sanitary No
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o a Uate � Permit No 1--// Z z
3 u KKKIIIJJJJ 3.50
w LL (APR 30 1968 )
a Fee 5
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� Applica ion is hereby made to the City of Cupertino for a permit to install plumbing
a w pipes and/or fixtures listed on the reverse side hereof, and agrees to install said prices
i m and/orfs*s t��acc r�l,�{r �i�il1t1rovisions of the Plumbing Code of the City of
< w Cupertmb,la d 3311 oth r aws applicable thereto.
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` ~ Use of Premises Residental ISwimming Pool
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,. 3 Owner Leroy Devine Address 10425 Tonita Way
i< PO Box 262
� z By Delta Plumbing & Pipelines Address Danville, Ca, 94526
O CONTRACTOR, AGENT
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- < Phone 837-9631
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u s State License #2b9299 Approved WILLIAM D E3EtJ7VIr .
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U PLUMBING INSPECTOR /
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FIXTURES NUMBER MAIN DRAIN
UNITS FEES UNITS FEES
Water Ileater Size
Water Closet Material
Bath Tub To Curb
Shower To Prop. Line
Lavatories To Existing
Kitchen Sink Not Conn.
Dish Washer. Sewer Box
Waste Disposal
Wash Tray STORM DRAINAGE
Washing Machine Size
Water Softener Material
Bar Sink 'Co Main Drain
Comb.Sink&Tray To Curb
Dental Unit
Drinking Fountain
Floor Drain WATER SYSTEM
Hopper Size
Restaurant Sink Material
Sand Trap TOTAL FEES
Urinal Fixture Fee
Area Drain Main Drain 1'ee
Water Leader Storm Drain Fee
Sprinkler Valve Water Sys.Fee
Relief Valve Gas Fee 1.50
Vac Breaker
Skimmer
Filter
Permit Fee 2 .00
Total Total Fee 3.50