Plumbing Permit Application /L���(' I ` ✓�L i LOT NO.,
h0. APPLICATION FOR PLUMBING PERMIT
w 9h1UG u 196&CITY�OP CUPERTINO
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r O Sanitary No.
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3 u Date Il_-•Ir `,� 'j: ,-
n+di96 8 Permit No
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W w Fee $ �
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� Application is hereby made to the City of Cupertino For a permit to install plumbing
o a pipes and/or fixtures listed on the reverse side hereof, and agrees to install said prices
I and/or fixtures in accordance with the provisions of the Plumbing Code of the City of
a Cupertino, and all other laws applicable thereto.
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LL Use of Premises Dwelling
00 2295 De La Cruz Boulevard
3 Owner D1t2 Crane Comp aay Address
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PaPlumbing Comps
J y 12ViSunnyvale-Saratoga Road
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CONTRACTOR,AGENT
3 245-2323
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Phan WILLIAM
z D. BENEVICH
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a o State License 186579 Approved
—U PLUMBING INSPECTOR
FIXTURES NUMBER MAIN DRAIN
UNrrs FEES UNITS FEES
Water Heater / Sizc
Water Closet ap' Material (/1
Bath Tub To Curb
Shower / To Prop. Line
Lavatories y To Existing
Kitchen Sink JIN,tConn.
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 SYS'T'EM
Hopper Size
Restaurant Sink Material
Sand Trap TOTAL FEES
Urinal Fixture Fee
Area Drain Main Ikain Fee t
Water Leader Storm Drain Fee
Sprinkler Valve Water Sys.Fee
Relief Valve Gas Fee
Vac Breaker
Skimmer
Filter
Permit Fee 0.7
Total Total Fee