51167.2LOT NO. 2Y
NO.
APPLICATION FOR PLUMBING PERMIT
d CITY OF CUPERTINO w p
x o ('j 11� Ilj} Sanitary No.
o Y ate �� � J ' 196 8 Permit No —1'5l�
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3 LL I U 3 L JQO Pee $ 30
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LL w Application is h�e��}' naJe�to the City of Cupertino for a permit to install plumbing
o npipcs an -door iTztures fisted �pn the reverse side hereof, and agrees to Install said rices
r `wand%or'fiidurU in accordance with the provisions of the Plumbing Code of the City of
i w Cupertino, and all other laws applicable thereto.
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Dwelling
n Use of Premises
00
3 Owner Ditz Crane ConpazW
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J By Palm PlumUng Company
CONTRACTOR,AGENE
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m Phone 215-2323
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a State License 186579
30"Pe La Cruz Boulevard
12A,,Su gTge-Saratoga Road
Approved /
PLUMBING INSPECTOR V
FIXTURES
NUMBER
MAIN DRAIN
UNITS FEES
UNITS FEES
Water Heater
/
Size 54
Water Closet
�j
Material 110-A
17th Tub
To Curb
Shower
To Prop. Line 1/
Lavatories
To Existing
Kitchen Sink
/
Not Conn.
Dish Washer
I 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
Drinkin Fountain
Floor Drain
WATER SYSTEM
Hopper
Size
Restaurant Sink
Material
Sand Trap
TOTAL FEES
Urinal
Fixture Fee
Area Digin
Main Drain Fee
Water Leader
Storm Drain Fee
Perm t Fee 2 dD
Total // �j,� Total Fee JaSV