51046 10660 Maplewood Rd.
OT NO,
NO. STRF.F.I'
-�aAPPLICATION FOR PLUMBING PERMIT
w i /_ t� CITY OF CUPERTINO
r o01" Sanitary No.
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3 a I�fe Crwt31�,J6 I 196_ Permit No .-/a
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10
Pee S
Or c0pl¢¢�1���++ n y iSSr b- made to the City of Cupertino for a permit to install plumbing
cc arlsl,ror I�jd��t���'pJthe reverse side hereof, and agrees to install said prices
Z and/or fixtures m accordance with the provisions of the Plumbing Code of the City of
a ) Cupertino, and all other laws applicable thereto.
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4 Use of Premises 4 Plex
20
3 Owner William White Address 365 La Prenda Way
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J, By Winchester Plumbing Co.' Address 1217 Dell Ave.
O CONTRACTOR, AGENT
3 < Phone 378-7615
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a o State License ('21096S Approved
– 0
PLUMBING INSPECTOR 1�
FIXI URESi MAIN DRAIN
UNITS FEES UNITS FEES
'Vater Hcate Size 5G/�
Water Closets d, Material L'Z,
Bath Tubs To Curb
Showers To Prop. Line
Lavatories To Existing
Kitchen Sinks (` F Not Conn.
Dish Washers Sewer Boxes
Waste Disposals
Wash Trays STORM DRAINAGE
Washing Machines Size
Water Softeners Material
Bar Sinks To Main-Drain
Comb. Sink & Trays To Curb
Dental Units
Drinking Fountains
Ploor Drains WATER SYSTEM
Hoppers Size
Restaurant Sinks Material 74—
Sand Traps TOTAL FEES
Urinals - Fixture Fee
Area Drains Main Drain Fee „2 C'z
Water Leaders Storm Drain Fee
Sprinkler Valves Water Sys. Fee O.
Permit Fee
TOTAL 1 TOTAL FEE
RECORD OF INSPECTION
Underground Rough
Partial Rough
Rough. Complete
Main Drain
Final .