51167.33
NOV 27 1968
FOR PLUMBING PERMIT
OF CUPERTINO
Sanitary No
Lot No. -05Pā
Date-%OCtoberm?94-r1TIP,11968 Permit 7. s
1 _ I Ul VV1 1-I%1
Fee So26, S --o
Application is hereby made to the 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
Owner Ditz Crane Co.
By Palm Plumbing Co.
Contractor, Agent
245-2323
Phone
Dwelling
De La Cras Boulevard
rensSunnyvale=Saratoga Rd.
State License 186579 / pproved WILLIAM D. BENEVICH
ā y4
x Plumbing Inspector
FIXTURES
NUMBER
I MAIN DRAIN
Units Fees
Units Fees
Water Heater
Size
Water Closet
tj
Material
Bath Tub
/
To Curb
Shower
To Pro . Line v
Lavatories
To Existinu
Kitchen Sink
N t Conn
Dish Washer
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 /(i
Area Drain
Main Drain Fee
Water Leader
Storm Drain Fee
Sprinkler System
Water Sys. Fee
Relief Valve.
Gas Fee
Vac Breaker
Skimmer
Filter
Permit Fee
Total
Total Fee