51187/AFR A 168
LOT NO.
`FOR PLUMBING PERMIT
OF CUPERTINO
Sanitary No.
15S11 .2/c
r" -W,61.29 °1968
Date . f, _ _ r� Ic%6— Permit No
7 Fee $ a 3.S -b
Application is hereby made to the City 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
Owner Di tz+.v Crane Co
By Palm Plumbing Co.
CONTRACTOR,AGENT
Phone 2115-2323
State License 186579
Address 2295 De La Graz Blvd.
Address 1234N - Hwy 9
Approved WILLIAM D. paM,.rl_SH
— U � I K PLUMBING INSPECTOR ✓
FIXTURES I NUMBER 11 MAIN DRAIN
UNITSI FEES 11 UNITS I FEES
Shower I/ I 11 T'o Prop. Line I ,-- I * I
Kitchen ink
Not Conn.
Dish Washer
Sewer Bnx
Waste Disposal
Wash Tray
STORM DRAINAGE
Washing Machine
Size
Water Softener
Material
Comb.Sink&Tray I 1 II To Curb
Drinking Fountain
Floor Drain WATER SYSTEM.
Hopper Size I I
M
Storm Drain
ee
Permit Fee I -e
Total Fee .--4