51177.1tom_ LOT NO. �/
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for, �4 C ION FOR PLUMBING PERMIT
Z a
Z t�. CITY OF CUPERTINO
r Sanitary No
oao CPaie OrAtR01y
196_ Permit No. S��%%•
W w Fee § S;2=4
O A i
li tih b• d h C' f C f I
pp ca on s ere y ma e to t e ty o upert no or a permit to install p umbmg
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 Single Dwelling
2295 De La Cruz Blvd., S. C.
Owner DSitz Crane Co. Address
By L. C. Bohart Plumbina Co.
CONTRACTOR, AGENT
To---- 245-2323
186579
State License
AIA7e,,E. Fremont Ave., Stvale
e—`I-�-
Approvedd
"\ PLUMBING INSPECTOR
Water Heater
Waste
Wash'
To Curb
WA
Water Sys. Fee
Total
Fees