51187'41��s— l-�'–cti`� V � � LOT NO. /L'
NO. ST FF.I'
APPL CA+�N�FOR PLUMBING PERMIT
`Coy. OF CUPERTINO
3 G
(p DD ll Sanitary No.
MareYl 29, X196&68 S�/ 7
Date 196_ Permit No
("Tv Pee$
Application is hereby'madeltojthe. 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 Dwelling
ng
ownerDitz Crane Co Address2295 Da 1• Graz Rlorir
R Palm Plumbing Co.
By CONTRACTOR,AGENT
245-2323
State License 186579
4.
1234 N. Hwy 9
WILLIAM D. BENEVICH
/� PLUMBING INSPECTOR
FIXTURES I NUMBER MAIN DRAIN
UNITS FEES UNITS I FE F.S
Water Closet I Z I II Material I/ / I I
Shower
11 To Prop. Line ti
Lavatories y
To Existing
Kitchen Sink
Not Conn.
Dish Washer
Sewer Box
Waste Disposal
Machine
To Curb
Floor Drain WATER SYSTEM I
Hopper Size
'roTAL
n cram r ee
Water Leader
opnnKler vm
Relief Valve
Vac Breaker
PermitFFeeee .�Z �� I
Total ,l�' 7�ota1