51187 (2)Ifj
LOT NO. 14 If
NO. STIUEET
AM C'TVr
PLUMBING PERMIT
IUPERTINO
AY 2� 1�A sanitary- No.
b 7
Dacey t96� Permit No ,5—it
(/�� U�� pp pp�� Fee $ 0Z 3-.1-a
Ap lica it iUreby4SmQdef&, d(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 DwelI Jng
Owner Ditz Crane Company
By Palm Plumbing Company
CONTRACTOR, AGENT
Phone 245-2323
186579
State License
J'r�sS De La Cruz Boulevard
A19Sunnyvale-Saratoga Rd.
Approved
—
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PLUMBING INSPECTOR ✓
FIXTURES NUMBER MAIN DRAIN
UNITS FEES UN ITS I FEES
Water Closet
To Curb
Material (� /
Bath Tub
/
To Curb
Shower
WATER SYSTEM
To Prop. Line
Lavatories
a—
To Existing
Kitchen Sink
/
Not Conn.
Dish Washer
Area Drain
Sewer Box
Waste Disposal
Storm Drain Fee
Sprinkler Valve
Wash Tray
Relief Valve
S'rORM DRAINAGE
ine
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
11 Bain Drain Fee
Water Leader
Storm Drain Fee
Sprinkler Valve
Water Sys. Fee
Relief Valve
Gas Fee
Vac Breaker
Skimmer
Filter
Permit Fee o2
Total
Total Fee �437J