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51177.1N a w Z 30JwU>zaw�JJ3W¢afY0WF 0 ou0 0O 0 7zJnZ0 /G�IGL LOT NO. NO QEl' f - A tFOR PLUMBING PERMIT®JUL 1319V" ,.OF CUPERTINO Sanitary No. DateIVO Permit No IV Fee $ off- �' S Application is hereby made to the City 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 Single Dwelling Owner Ditz Crane Co. 229Ay g La Cruz Blvd, S. C B Bohart Plumbing Co. 161Ah� Fremont Ave., SIvale Y CONTRACTOR, AGENT Phone 245-2323 n n -7 0 O'�1/W .WtCi'/� State License 186579 Approved PLUMBING INSPECTOR C/ FIXTURES NUMBER MAIN DRAIN Units FeesUni Fees Water Heater Size Water Closet Material Bath Tub To Curb Shower To Pro .Line Layatories _ •. -� To Existine Dish Washer Waste Disposal Wash Tray STORM DRAINAGE Washing Machine Size _ -Water Softener Material Bar Sink To Main Drain Comb.Sink & Tray To Curb Dental Unit Drinking Fountain Floor Drain WATER SYSTEM Ho er Size Restaurant Sink Material Sand Tra TOTAL FEES Urinal Fixture Fee (/ Are ain Main Drain Fee - W e F Sprinkler System Water Sys. Fee Vac Breaker Skimmer Filter Pool Sweeper Permit Fee Total Total Fee