51187I¢ O
U
LOT NO. 7/
NO. *0RAUMBING
,Nr, ICA -TION PERMIT
JUN 1'�S6b F l`PF.RTINO
Sanitary No. J37� �7
d An9i Qs n.- 8 Permit No 5//o
Date GO
�� r � �'� TINO Fee .$ -2
Application is hereby made to the City 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 Dwelling
Owner Ditz Crane Co.
By Palm Plumbing Co.
CONTRACTOR,AGENT
Phone 21x5-2323
State License 186579
22V De La Cruz Boulevard
A Less
4d3AeSunn°ale Saratoga Rd.
Approved
APLUMBING INSPECTOR
FIXTURES I NUMBER �� MAIN DRAIN
UNITS FEES UNITS FEES
Shower i, I H To Pron. Line I -- I
Kitchen ink
Dish Washer
Waste Dispo
Comb.Sink & Tray To Curb
Dental Unit '
Drinkin Fountain
Floor Drain 11 WATER SYSTEM
Size
Area Drain
Water Leader
TOTAL
Total I <f,(jj� r 11 Total Fee 1 Zr 1