51187N Q
z
NO.
LOT NO. 4
PLUMBING PERMIT
CUPERTINO
NN Sanitary No.
Date June'10; �68 1}y�j8 Permit No
phCITY ��dE{ _ Pee $
ApcahonQsFher jN�ity 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 Dwelli nv
Ditz Crane Co,
?2A5 De La Cruz Blvd,
ress
B Palm Plumbing Co, sJunnyvale-Saratoga Rd,
I CONTRACTOR,AGENT
Phone 245-2323
State License 186579
Approved WILLIAM D. 3ENEVICH�
PLUMBING INSPECTOR
FIXTURES
NUMBER
MAIN DRAIN
UNITS I FEES
11 UNITS FEES
Water Heater
/I
Isize
Weser Closet
Material
Bath Tub
/
To Curb
Shower
/
To Prop. Line
Lavatories
To Existing
Kitchen Sink
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
WATER SYSTEM
Hopper
Size
Restaurant Sink
Material
Sand Trap
'TOTAL FEES
Urinal
Fixture Fee
Area Drain
Main Drain Fee
Water Leader
Storm Drain Fee
Sprinkler Valve
Water Sys. Fee /
Relief Valve
as Fee
Vac Breaker
Skimmer
Filter
Permit Fee c2
Total
// y
Total Fee oz