51167.2IY/�Jl /.� /� Al LOT NO. A/
NO. STREET '7
A�P.PICAI-.FOR PLUMBING PERMIT
® T - CUPERTINO
Date f MAY &317 t 8
Sanitary No.
Permit NoL—
Fee $ 4-6, Cr)
ApplafifisrebyVjffl�Fp- of Cupertino for a permit to install plumbing
pipes and/or fixtures listed on e reve se 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 Company
B y Palm Plumbing Company
3 0 CONTRACTOR, AGENT
- F: Phone 245-2323
os State License 186579
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295 De La Cruz Blvd.
Ad ress
AIA? e3S Sunnyvale -Saratoga Rd.
WILLIAM D. BENEVICH
X PLUMBING INSPECTOR
FIXTURES
NUMBER
MAIN DRAIN
UNITS FEES
UNIYS FEES
Water Heater
Size
Water Closet
Material
Bath Tub
/
To Curb
Shower
To Prop. Line
Lavatories
To Existing
Kitchen Sink
/
Not Conn.
Dish Washer
Sewer Box
Waste Disposal
-
Wash Tray
TORM DRAINAGE
Washing MachineSize
Water Softener
Material
Bar Sink
To Main Drain
Comb.Sink & Tray
To Curb
Dental Unit
Drinkin Fountain
Floor Drain
WATER SYSTEM
Hopper
Size
Restaurant Sink
Material
Sand Trap
TOTAL FEES
Urinal
Fixture Fee
Area Drain
Main Drain Fee
Water Leader
Stom Drain Fee
rinkler Valve
Water Sys. Fee /
Relief Valve
Gas Fee
Vac Breaker
Skimmer
Filter
Permit Fee
Total
Total Fee GSv
LOT NO.lee
NO`Yti @® �J'
'� a CI MIT
OR
or CLTPERT1No �� 7
I��AY 2 7 ���� Sanitary No.
Date Permit No. 6 7 -2 --
Ap`phca%ion Is here�iy made for a permit to
a — —,9 story, Type ._..__ __y J Building
to be occupied only as_ in accordance with
Plans, Specifications and Plot -Plan filed herewith. Pl Ck Fee
Estimated Value of Improvements, S 2 (f) 1200_. Fee $ cg�� IS-0
It is hereby agreed that the requirements of the Cupertino Building and "Zoning Ordinances and
all other laws applicable to the construction, location, and use of buildings within the City of
Cupertino will be complied with. DI Z-CIZANE
Owner Address 229 Ar LA CRUZ ex��tR
By- Address SANTA CLARA, CALIF. 95031)
Phone o�.$�� —///
State License I- 1 221- —
Approved WILLIAM U. tsrrivi::dlc:t{
BUILDING INSPECTOR
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