51187a. O
-60
LOT NO. 4Y
NO. I. STREET - '^
AP,P,L`ICA,�TION, FRQR PLUMBING
`� �-=-zNl7fi' OP CUPERTINO
to I Sanitary No
PERMIT
Date 'Maieh glsl 196 a 196— Permit %
�� Pee $
Application�is hereby^made to'the-City of Cupertino for a permit to install plumbing
pipes andm 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 Co.
Address 2295 De La Cruz Blvd.
By 1234 N. Hwy 9 Address Palm Plumbing Co.
CONTRACTOR, AGENT
Phone 245-2323
State License 186529
d VALLIP.I D. dC4rICH
V-_ PLUMBING INSPECTOR
FIXTURES
NUMBER MAIN DRAIN
UNITS FEES UNIT FEES
Water Heater
/ Size
Water Closet
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 Main Drain
Comb.Sink & Tray
lo Curb
Dental Unit
Drinkins Fountain
Floor Drain WATER SYSTEM
Hopper Size
Restaurant Sink I 1 11 Material
�nua� r�xture ree -� ei
Area Drain il7ain Drein Fee ;'�
Water Leader Stem Drain Fee
Sprinkler Valve Water Sys. Fee I/,
ee
Filter
Permit Fee
Total %� j7% 'Total Fee �(J