51187[O F
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LOT NO.
ZA LFOR PLUMBING
�E►r OF CUPF.RTINO
(AUG 3 gg fft Sanitary \'c
PERMIT
Dat 196
(�C (J 1968 Permit No ,5 /e1
XI}S t bhr f41�4s#lkl WO Fee 5 to 3 J�1
PT, h ati is e City of Cupertino Cora permit In 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
Ditz Crane Company
By Palm Plumbing Company
y CONTRACTOR, AGENT
n - 215-2323
State License 186579
2�ydDe La Cruz Boulevard
ress
Wd�Fessunrwvale-Saratoga Rd.
Aaaroved ;JILLVIA D. BENEt%'
,\ PLUMBING INSPECTOR
FIXTURES
NUMBER
MAIN DRAIN
_
UNITS FEES
UNITS FEES
Water heater
/
Size 1.114
Water Closet
.X—
Material
Bath Tub
/
To Curb
Shower
/
To Prop. Line
Lavatories
2—
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
Drinkin Fountain
Floor Drain
WATER SYSTEM
Hopper
Size I I
Area Drain Main Drain Fee��
Water Leader Storm Drain Fee
ee
Permit Fee
Total Fee