NO PERMIT NUMBER (2) -/�� Lor NO.
NO. /A REE.T —�
APLS
� FSR PLUMBING PERMIT
° d i �PVI� TING
z �ranitary No.
° a Date l T
Permit No
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w Pee S 4'-�'� 62I
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Application is ��}�/m. tn hno [ora permit to install plumbing
o w pipes and/or fixtu'rt Il i4ted�tih ttfd4kCefeCi df��reof, and arees to install sid prics
> I 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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a Use of Premises DWAI lino
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3 Owner Ditz Crane Company A2A5 De La Cruz Boulevard
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B Palm Plumbing Company 7A2�sSumwvale-Saratoga Road
J O y CONTRACTOR, AGENT
3 m Phone 2 5-2323
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W State License 186579 Approved
a O T
C V PLUMBING INSPECTOR
FIXTURES NUMBER MAIN DRAIN
UNITS FEES UNITS FEES
Water Heater Size
Water Closet 1--7 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 To Curb
Dental Unit
Drinking Fountain
Floor Drain WATER SYSTEM
Hopper Size
Restaurant Sink Material
Sand Trap TOTAL FEES
Urinal Fixture Fee Aosig
Area Drain Main Drain Fee
Water Leader Storm Drain Fee
Sprinkler Valve Water Sys.Fee
Relief Valve Gas Fee /
Vac Breaker
Skimmer
Filter
Permit Fee
Total Total Fee ti(�