51005 s 1 Ao' r.".o.
NO. STREET
APPLICATION FOR PLUMBING PERMIT
z i-i CITY OF CUPERTINO
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x o Sanitary No.
LL
3 a Date October 29 196-4 Permit No 'Y7
Q 10,
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i LL Pee $ 4.00
0 Application is hereby made to the City of Cupertino for a permit to install plumbing
o a pipes and/or fixtures listed on the reverse side hereof, and agrees to install said prices
a and/or fixtures m accordance with the provisions of the Plumbing Code of the City of
a w Cupertino, and all other laws applicable thereto.
w x
LL Use of Premises HOUSEHOLD
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Owner K. T. McGu i re Address
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Z By Address rOWEur
O CONTRACTOR, AGENT .
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— 607 THE ALAMEDA
W Phone ✓E'--jy-3'r .
w z JOS LIF.
ao State License z1 3 �� / Approved
U PLUMBING INSPECTOR
FIXTURES NU, BER MAIN DRAIN
UNITS FEES UNITS FEES
Water Heate Size
Water Closets Material
Bath Tubs To Curb
Showers To Prop. Line
Lavatories To Existing
Kitchen Sinks Not Conn.
Dish Washers Sewer Boxes
Waste Disposals
Wash Trays STORM DRAINAGE
Washing Machines Size
Water Softeners goo Material
Bar Sinks To Main Drain
Com . Sink-& 'rays To Curb
Dental Unit?' =`�
Drinking Fountains
Floor Drains WATER.SYSTEM _
Hoppers Size
Restaurant Sinks Material
San Traps TOTAL FEES
Urinals Fixture Fee' / t-Z'
rea Drains Main Drain Fee
Water-Leaders Storm Drain Fee
Sprinkler ValvesWater Sys. Fee
Permit Fee
TOTAL TOTAL FEE o0
RECORD OF INSPECTION
Underground Rough...
Partial Rough..
Rough Complete-
Main Drain
Final...