51167.2 (2)/4�t�G/gLG/ LOT NO.
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NO. STREET
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PLUMBING PERMIT
CUPERTINO
MAY 13 1968 sanitary No.
Date >' '966 Permit No �X/ G
�Ir``// //fi�r- rr I Cee
Apptteatioh isthcreby7LADERTS'(0�y 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 Dwellimg
Owner Ditz Crane Co.�g� r,De La Curz Boulevard
B Palm Plumbing Co, W�SF- Hwy 9
By CONTRACTOR, AGENT
VI,--- 245-2323
State License. 186579 Approvedl': i:.:.'— • • k
7� PLUMBING INSPECTOR -
FIXTURES
NUMBER
MAIN DRAIN
UNITS FEES
UNITS FEES
Water Heater
Size
Water Closet
Z-
Material
Bath Tub
To Curb
Shower
/
To Prop. Line
Lavatories
To Existing
Kitchen Sink
/
Not Conn.
Dish Washer
Sewer Box
Waste Disposal
Wash Tray
STORM DRAINAGE
Washin Machine
Size
Water Softener
Material
Bar Sink
To Main Drain
Comb.Sink & TrayTo
Curb
Mental Unit
Drinkin Fountain
Floor Rain
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
Water Sys. Fee
Relief Valve
Gas Fee
Vac Breaker
Skimmer
Filter
Permit Fee 2.Q?�
Total
Total Fee