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LOT NO.
NO. STREEI'
APPLICATION FOR PLUMBING
C[Tk FII ICUPERTINO
(JUN 12 1968 FI
'l ,. Sanitary No
PERMIT
,3 y13c
Date—j une 10, 1968 Permit No
I-��\J r Qjlltg 'I' A1� Pee $ d— 'r-6
Applicat & is hereby Ina ettd-th`e City f 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 Co.
By
Palm Plumbing Co.
CONTRACTOR, AGENT
Phone 245-2323
State License 186579
WdfesDe La Cruz Blvd.
1A2 Sunrrivale-Saratoga Rd.
Css
WILLIp'.7.I D. -ViC11
Approved
X PLUMBING INSPECTOR
FIXTURES I NUA16ER MAIN DRAIN
UNITSI FEES 11 UNITS I FEES
Shower /
To P,.p. 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
To Main Drain
Comb.Sink & Tray
To Curb
Dental Unit
Drinking Fountain
Floor Drain
WATER SYSTEM
Hopper
Size
Drain
fixture N ee
Storm Drain Fee
ee
Permit Fee
Total Fee