511871J
LOT NO.
NO. STREET
APPLICATIONS FOR PLUMBING PERMIT
E (71TYI`sOF CUPERTINO
(PPR n. 1gP8II
March 29; 1968 1 Q
sanitary No.
Permit Nom%
r, -.v nr-nr�TI; t� Pee $
s '+I :n
Application is hereby made to tlic 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 alt other laws applicable thereto.
Use of Premises Dwelling
Owner Ditz. Crane Co. Address 2295 De La Cruz Blvd.
By Palm Plwnhing Co.
CONTRACTOR,AGENT
Phone-45—?323
State License 185579
Address 1234 N. Hn 9
Approved WILLIAM D. HENEVICI
PLUMBING INSPECTOR ✓
V
FIXTURES I NUMBER II MAIN DRAIN
UNITS1 FEES 11 UNIT
Closet
Shower I / I II To ProD. Line 1 s� 1
Kitchen ink
Dish Washer
Waste Dispo
Machine
Comb.Sink & Tray I 1 11 To Curb
Floor Drain I 1 11 WATER SYSTEM I
Restaurant Sink �� Material
Sand Trap TOTAL FEES
Water Leader
Main Drain Fee
Water
Permit Fee
Total // c jy Total Fee
I