51187162'S'11 7 / /NSO hJ 7 OF LOT NO.
NO. STREET'
CITYOF CUPERTINO CITY OF CUPERTINO
" < �' APPLICATION FOR PLUMBING PERMIT
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���� s 1911 Sani Clry No.oQ t)ate a' 1971 Permit No S I/lf—%
3 LL I� Fee 5 J 42-
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� 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
> and/or fixtures in accordance with the provisions of the Plumbing Code of the City of
a w Cupertino, and all other laws applicable thereto.
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w Use of Premises /[eslo?�,rJCF
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Owner
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CONTRACTOR,AGENT
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Phone
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State License
Address X�C
AddressVii'.
Approved`
PLUMBING INSPECTOR
FIXTURES
NUMBER MAIN DRAIN
Units Fees Units Fees
Water Heater
Size
Water Closet
Material
Bath Tub
To Curb
Shower
To Prop. Line
Lavatories
To Existing
Kitchen Sink
Not
Dish Washer
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
Area Drain
Main Drain Fee
Water Leader
St rm Drain Fee
Sprinkler System
Water Sys. Fee
Refief Valve
I Gas Fee
Vac Breaker
Skimmer
Filter
Pool Sweeper
Permit Fee �—
Total
Total Fee
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1
1l� '. / E LOT NO.
NO. STREET'
APPLIC- O� TNG PERMIT
T
October' I O C T� g� 81968 s.l I� E a No
/� Pee $ � 3_ Sy
Application is herebyrmaT"'ItoghFCiCyLjPReVAnTor 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
Ditz Crane Company 2225 De La Cruz Boulevard
Owner -
pa3�yl Plumbing Compal
By CONTRACTOR, AGENT
Phone 2115-2323
186579
State License
12 Sunrr9vale-Saratoga. Rd.
Wdrre55
VELLIAN;i D.
.k- PLUMBING INSPECTOR 11
FIXTURESNUMBEII MAIN DRAIN
UN PIS FREES IINTTS FFE.0
Material
Kitchen $ink / Not Conn.
Dish Washer Sewer Box
Waste Disposal
Comb.Sink&Tray I 1 II To Curb
Fountain
WATER SY
Size
909j"m
ee
Water Leader
Sprinkler Valve
Relief Valve
Vac Breaker
Total Total Fee I � v