51167.2LOT NO. G
NO. Y//STR F. EI'
AP CAQ[i PLUMBING PERMIT
®` C TING
S q�r� anitary No.
Date — / EP 9 �F966" Permit No ��iG 7.
//��' �/ Fee $ a 3
Application isiFie�e6}' ��e t it yl ertino for a permit to install plumbing
pipes and/or fixtures listed on t e re d ereof, 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 DWeLUnR
Ditz Crane Company 2A2.94 ?e La Cruz B oulevard
By Palm Plumbing Co#Pany ] §.mu)yvale-Saratoga Rd.
CONTRACTOR, AGENT
Phone 2452323
State License 186579
Approved
v 1
ed Wt� .A47
�C PLUMBING INSPECTOR v
FIXTURES NUMBER I MAIN DRA[N
UNITS I FEES UNI'CS FEES
Shower
To Pro . Line
Lavatories L
To Existin
Kitchen Sink
Not Conn.
Dish Washer
Sewer Box
Waste Disposal
Wash Tray
STORM DRAINAGE
Washing Machine '/
Size
Comb.Sink & Tray To Curb
Dental Unit
Drinking Fountain
Floor Drain WATER SYSTEM
Hopper Size I I
Area Drain Main Drain Fee
Water Leader Storm Drain Fec
ee
Permit Fee
Total Fee