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R PLUMBING PERMIT
�� TCUPERTINONrf
MAY 21 Iwo sanitary No. s
Date May 15. 967 Permit No
(`ITS/ ((�� (��II f��jj[[ppT7��nl PeeS w�,SZI
Applitaltiod isrt F,b}CIH lcr-tt3. lltt'�i y of Cupertino for a 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 Dwelling
Owner Ditz Crane Company
By Palm Plumbing Company
CONTRACTOR,AGENT
Phone 2115-2323
186579
State License
Ao?rl2r,9g De La Cruz Boulevard
Add} Sunnyvale -Saratoga R i,
WILLIAM D. 6cNEVICH
Approved
�( PLUMBING INSPECTOR
FIXTURES
NUMBER
MAIN DRAIN
UNITS FEES
UNITS FEES
Water,later
f
Size 4
Water Closet
J'
Material (4 /
Bau
/
To Curb
Shower
/
To Prop. Line
Lavatories
3
To Existin
Kitchen Sink
Not Conn.
Dish Washer
Sewer Box
Waste Disposal
Wash Tray
STORM DRAINAGE
Washing Machine
/
Size
Water Softener
Material
Bar Sink
To 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 0
Area Drain
Main Drain Fee '
Water Leader
Storm Drain Fee
Sprinkler Valve
Water Sys. Fee
Relief Valve
Gas Fee
Vac Breaker
Skimmer
Filter
Permit Fee 2//-F
Total
Total Fee "(i
/V S i w,
I.OT NO. -
NO. STREET 0
W z LI ION FOR BUILDING PERMIT
r o OF CUPF.RTINO
o a Sanitary No.
W o Uate` / i9sa _t'6R Permit No.
o W lication is hereb made for a permit to
z N a b"�' `' �stoq, R1 Building
aW
ato be occupied only as �' i dance with
0 o plans, Specifications and Plot -Plan filed herewit . Pl Ck Fee
F_ 3 Estimated Value of Improvements, $ 20000.170 Fee $ 29 00
z J It is hereby agreed that the requirements of the Cupertino Building and Zoning Ordinances and
* Z all other laws applicable to the construction, location, and use of buildings within the City of
J o Cupertino be complied with.
3P
N Owner Address
WZ
W a BAddress
a u Phones �� U�� Approved WILLIAM D. BENEVICH -
State License /V. BUILDING INSPECTOR