51167.2�D 117R-2- I 7A' gC�f 45;&0 LOT NO. V /
NO. STEM
s=R L�ICAaTION�O FOg�R PLUMBING
PERMIT ERMIT
z �ITY CUPERTINO
o Sanitary No.
o Date J
7
96
196_ Permit No
S//67. a
3`
LL 1 Y rilpF Fee$o2(a.JZ
To
1
Application is erebylmade"t t7r G`ity of Cupertino for a permit to install plumbing
`o 1- 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
a W Cupertino, and all other laws applicable thereto.
wx
LL Use of Premises 11t'Pel1T>7g
0 3 Owner Ditz Crane Company Addresss95 De La Cruz Boulevard
ZJ7��
B Palm Plumbing Company A rens unnyvale—Saratoga Rd
J O y CONTRACTOR, AGENT
3< 245-2323
— N Phone
wz
w w
Qo State License 186579 Approved
�U x PLUMBING INSPECTOR
FIXTURES I NUMBER MAIN DRAIN
UNITS FEES UNITS I FEES
Water
Shower To Prop. Line I ✓
Levatories 1 i To Exi Stine
Kitchen 5ink
Dish Washer
Waste Dispo
Comb.Sink&Tmy I 1 11 To Curb
Floor Drain I 1 11 WATER SYSTEM
Area Thain Main ee
Drain Fee (j'�
Water Leader Storm Drain F
Sprinkler Valve I I I I Wale' Svs. Fee I
Relief V
Vac Bre
Skimmer
Filter
Permit Fee
Total Fee