51177.16 L) I /w i✓ //'/ LOT NO. //
NO. STREET
LT N FOR PLUMBING PERMIT r7
p Y
OF CUPERTINO
(p t%tYs �1��19 Sanitary No.
Da((t��e ��// ���� //�� ,'196— Permit No
Fee
Qpyat, is CWERTINO, City of Cupertino for a permrt�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 Single Dwelling
Owner Ditz Crane Co. A2d ?,lsDe La Cruz Blvd., S. C.
J, By L. C. Bohart Plumbing
O CONTRACTOR, AGENT
3 Phone 245-2323
< o tate License 186579..
-U
Co. A167 East Fremont Ave., S;vael
A -21-7v
Approved
`\ PLUMBING INSPECTOR
FIXTURES
Units
Comb.Sink &
Dental Unit
Size
Size
WATER
Water Sys. Fee