NO PERMIT NUMBER LOT NO.1
NO, STR YF�.F.1 ^m
APPLICAll ONS:F. , R PLUMBING PERMIT
id CITY OP CUPF.RT(NO
w AUG 12 1968 e sanitary No.
fo
Y
pLL
o a Date duly 196 8 Permit No
i LLt - i iut�[i1T'"O Fee $ of 3O d
o Application is hereby made to the City of Cupertino for a permit to install plumbing
'opipes 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
a w Cupertino, and all other laws applicable thereto.
Dwelling
w x
LL Use of Premises
° O Ditz Crane Company 2295 De La Cruz Boulevard
0 3 Owner
Ad ress
0
By Palm Plumbing Company 1SSurznyvale-Saratoga Rd.
O y CONTRACTOR, AGENT
3 m Phone 21x5-2323
wz
w w 186579 WILLIAM D. BENEVIC-
U State License Approved
PLUMBING INSPECTOR
FIXTURES NUMBER MAIN DRAIN
UNITS FEES UNITS FEES
Water Beater Size
Water Closet Material L
Bath Tub To Curb
Shdwer 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 R.zter Sys.fee
Relief Valve Gas Fee
Vac Breaker
Skimmer
Filter
Permit Fee
Total j1W 11 Total hee a