51187LOT NO. 1425
-" N6.�!1 STREF.I'
APPLICATION', FOR PLUMBING PERMIT
"< PCITY OF CUPERTINO
WR 4, 1968 r,
x 0 Sanitary No. .S
3a Date'-��march 29,_ 1968 I y 196_ Permit No�97
U :rl.`I�l.tt�L,.t/ Fee
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Application is hereby made to the City of Cupertino for a permit to install plumbing
'opipes and/or fixtures listed on the reverse side hereof, and agrees to install said prices
r < 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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4 Use of Premises DKelling
00
3 Owner Ditz Crane Co. Address 2295 De La Cruz Blvd.
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J z By palm PlvmhinD CO Address 123), N" HW9
O CONTRACTOR, AGENT
3 i:245-2323
— < Phone
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w w 186579 WtLLI:<tVl D. LLAd�VICtt
eo State License Approved
U ./ PLUM13ING INSPECTOR
FIXTURES
NUMBER
MAIN DRAIN
UNITS FEES
UNITS FEES
Water Heater
Size
Water Closet
3
Material
Bath Tub
To Curb
Shower
To Prop. 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 Hain 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 DrainMain
Drain Fee
Water Leader
Storm Drain Fee
Sprinkler Valve
Water Sys. Fee
Relief Valve
Gas Fee
Vac Breaker
Skimmer
Filter
Permit Fee -2
Totalgr
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Total Fee 3 j�