51167.2No. Street
APPLICATION FOR PLUMBING PERMIT
CITY OF CUPERTINO
Lot No.
Sanitary No. GIOS 13P
Date -' X_2' , 196 —Permit No. 49110_112-
- I� Fee Set C_
Application is hereby made to the City of`Cupertinofort alpe�mit toliiistall plumbing pipes
and/or -fixtures -listed -on -the -reverse side -hereof,, and-agrees`'to install-said,phces-and/or fixtures- - -
in accordance with the provisions of the Plumbing Code of the City of Cupertino, and all other
laws applicable thereto. r. -�/ „_ ♦,�1��4t.,_�
Use of Premises
])we, ink
Owner Ditz Crane Company
By Palm Plumbing Company
Contractor, Agent
Phone
245-2323
State
186579
WDe La Cruz Boulevard
ess
]2A4 Sunnyvale -Saratoga Rd.ss
v Approved
Plumbing Inspector J
NUMBER
Water Heater
Wash
Comb.Sink &
Dental Unit
Drain
Material