51187LOT NO.NO. EPPG
A_PPL� ATIOWFO kfLUMBING PERMIT
z d ± CITY OPG PIiRTINO
X TfJUN 12 1968 t,l' sanitary r.�n. S70'? d�=
3 4 _
a Date June' i 0, 196
U 8 Permit No
_ t I F CUPERTINO Fee S�3-�
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� Application is hereby- made to the City of Cupertino for a permit to install plumbing I
o a pipes and/or fixtures listed on the reverse side hereof, and agrees to install said prices
rI and/or fixtures in accordance with the provisions of the Plumbing Code of the City of
a w Cupertino, and all other laws applicable thereto.
w x
a ~ Use of Premises Dwelling
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00
,'_ 3 Owner Ditz Crane Company a�616sDe La Cruz Blvd.
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By. Palm Plumbing CO. 12,v, Sunnyvale Saratoga Rd,
O CONTRACTOR, AGENT
3 Phone 245-2323
w w WILD."-.FF. D. S�NZYICH
u Y State License 186579 Approved
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/
'e IV PLUMBING INSPECTOR ✓
FIXTURES NUMBER MAIN DRAIN
UNITS I FEES UNITS I FEES
Water
Shower I / 1 11 To Proa. Line I ✓ I
Kitchen Sink
Dish Washer
Waste Dispo
Machine
Materi
Comb.Sink&Tray I 1 11 To Curb
Floor Drain WATER SYSTEM
Hopper Siae
■ Urinal
Valve
Vac
TOTAL
' Total Total Fee