51182z Q
w�
NO. STREET
MAY 31 1968
Date May 23•
LOT
KING PERMIT
INO
nittry No.
Permit No, 2—
CITY
CITY C 1� T�nl� Fee $ 3.50
Application is he9b� mace t I ky f Cupertino Fora permit to install plumbing
pipes and/or fixtures listed on the reverse side hereof, and agrees to install said prices
and/or fixtures in accordance with the provisions of the Plumbing Code of the City of
Cupertino, and all other laws applicable thereto.
Use of Premises HOUSEBOID
Owner FRED W. KAAZ Address 21463 SHANNON CT.
By SOFPMASTER. Inc. Address P.O_ Bnx 606
CONTRACTOR, AGENT
Phone 3.79..3050
State License 234281
Approved
PLUMBING INSPECTOR
141XTURES D
UNITS FEES
UNITS FEES
Water Heatc
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
Wasll Trays
STORM DRAINAGE
Washing Machines
Size
Water Softeners
Material
Bar Sinks
To Main Drain
Com . Sink s Trays
To Curb
Dental Units
Fountains
rains
WATER SYSTEM
s
Size
ant Sinks
Material
AnkFg
raps
t. j
TOTAL FEES
Fixture Feerains
'
Main Drain Fee
Leaders
r Valves ,� /
Storm Drain Fee
Water Sys. Fee
'lPermitFeeL
TOTAL FEE J,,J0
RECORD OF INSPECTION
Underground Rough
Partial Rough
Rough. Complete
Main Drain
Final