51177.1� I A6*t,, � / "�' L �/ LOT NO.
h0. �EE.T
APPLICATION
o Tt v
FOR PLUMBING PERMIT
OF CUPERTINO
MAM IMMILLS 11 Im
Sanitary No.
Permit No 7 ?,-
Fee
lFee 5 .2 3 St)
A licatio h �t�,(�ig City of Cupertino for a permit to install plumbing
pips�a�i/otuy hll{ everse side hereof, and agrees tb install said prices
and or xtures 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. 229q%J?g5La Cruz Blvd. S. C.
By Bohart Plumbing Co. 167AA.e�Ront Ate, Stvale
CONTRACTOR, AGENT
Phon ?45-2323
State License 180579
I -lo -To
pproved
PLUMBING INSPECTOR
Water Heater
Ff
Wash
Total
MAIN
Material
To Curb
Water Svs. Fee
Fees