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NO. STREP.T I N R PLUMBING PERMIT
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CUPERTINO
°N 26 1968 8 Sanitary No
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J Date 196— Permit No �si// G� 7• Z,
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u Pee $ c� 3 S�
LL QUY QC �S�PERTINO
° Applic o s h by a e to t e City of Cupertino for a permit to install plumbing
w pipes and/or fixtures listed on the reverse side hereof, and agrees to install said prices
a and/or fixtures in accordance with the provisions of the Plumbing Code of the City of
m Cupertino, and all other laws applicable thereto.
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Use of Premises Dwelling
Ditz Crane Company 295 De La Crus Boulevard
Ad ress
B Palm Plumbing Company A3&4, Sunnyvale—Saratoga Rd.
By CONTRACTOR. AGENT
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--- 245-2323
State License 186579
Approved O /L/
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MBING INSPECTOR
FIXTURES I NUMBER �� MAIN DRAIN
UNITS FEES UNITS FEES
Water Closet I —L' 1 11 M.fP�;.,l I // I I
Kitchen $ink / Not Conn.
Dish Washer Sewer Box
Waste Disposal
!IL'IF er.Tel7
Material
Comb.Sink&Trey I 1 11 To Curb
WATER SY
Sand Trap I 1 II TOTAL FEES
Wruatecar L.n n.0 main cram ree �v�
eader Storm Drain Fee
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Permit Fee
Total ; �{7f Total Fee ��