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14,/ - LOT NO.
NO.—
T�J'Y
R&=O�FOR PLUMBING PERMIT
. TY "Op CUPERTINO
x o MAY 31 196$ V_ Sanitary No.
3 a Date May 15., 19(� Permit No `���� 7
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= w � V l r r"UPER 1 INO Fee
O 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 w Cupertino, and all other laws applicable thereto.
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Use of Premises Dwelling
Owner Ditz Crane Company
By Palm Plumbing Company
CONTRACTOR, AGENT
Phone245-2323-2323
State License1-86579 —
A SRf De La Cruz Boulevard
A 4 Sunnyvale -Saratoga Rd.
WILLIAM D. BENEVICA
Approved
Q PLUMBING INSPECTOR
FIXTURES NUMBER 11 MAIN DRAIN
UNITS1 FEES 11 UNITS I FEES
Material
Jhower
11 To Proi). Line
Lavatories 1
To Existing
Kitchen 5ink
Not Conn.
Dish Washer
Sewer Box
Waste Disposal
Water Sys. Fee /
DRAINAGE
Washing Machine
11 Size
Water Softener
Material
Bar Sink
To Main Drain
Comb.Sink & Tray
To Curb
Fountain
WATER
Si ze
Jand'['rap
TOTAL FEES
Urinal
Fixture Fee
Area Drain
Main Drain Fee
Water Leader
Storm Thain Fee
Sprinkler Valve
Water Sys. Fee /
Relief Valve
Gas Fee
Vac Breaker
Skimmer
Filter
Permit Fee .2er-0
Total
� (f Total Fee sd