51187-U I
N O:^
APPL
APR n.
LOT NO.,��
ATION FOR PLUMBING PERMIT
71068 4-
OF CUPERTINO
y .
Sanitary No
Uate n, march 28,_ 1968 196_ Permit No
f .. Fee $ �R 3 Sb
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 Dwelling
2295 De La Cruz Boulevard
Owner Ditz Crane Co. Address
B Palm Plumbing Co. ] 3,4 North Hwy 9
y Address
CONTRACTOR,AGENT
p -e 245-2323
186579 WILLIAM D. M—EN^_V11CH
State License.
X PLUMBING INSPECTOR
FIXTURES
HUMBER
MAIN DRAIN
UNITS I FEES
UNITS FEES
Water
I
Isize-
Water Closet
3-
Material e4/
Bath 'Cub
/
To Curb -
Shower
/
To Prop. Line
Lavatories
To Existing
Kitchen ink
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
WA'T'ER SYSTEM
Ilopper
Size
Restaurant Sink
Material
Sand Trap
TOTAL FEES
Urinal
Fixture Fee
Area D ain
Main Drain Fee
Water Leader
Stonnn Drain Fee
Sprinkler Valve
Water Sys. Fee �
Relief Valve
Gas Fee sV-79
Vac
Total Fee