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51167.2 (3)LOT �+' APPLICATION FOR PLUMBING PERMIT 'MAY 6 1968 CITY OF CUPERTINO Sanitary No. Ihte- +ZJ`n.!nYgT, n 1968 Permit No -6 l/E7. 1/ Pee $ 02 -S-'a 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 Company By Palm Plumbing Company CONTRACTOR,AGENT Ph 245-2323 on State License 185579 d9ss651 De La Cruz Boulevard ,Yd 4sN. Hwy* 9 PLUMBING INSPECTOR I,,- FIXTURES NUMBER MAIN DRAIN UNITS FEES UNITS FEES Water Healer Size 41, Water Closet Material III Bath Tub % To Curb Shower / To Prop. Line Lavatories t 3 To Existing' Kitchen ink % Not Conn. Dish Washer Sewer Box Waste Disposal Wash Tray STORM DRAINAGE Washin 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 ';J -el 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 ��(T 1 Total