51167.2I/ LOT NO. 1
NO. STREET
APPLICATION FOR PLUMBING PERMIT
CITY OF CUPERTINO Q'
® Sanitary No.
Date ""�' 196 8 Permit No Jr�� 7. o2,
✓(I Fee S a L
A'Pgg,,ication s 6�rebysm, de to dy of Cupertino for a permit to install plumbing
pilr� g,ia /qj fixtures list /ersc side hereof, and agrees to install said prices
and/or fixtu'cs i accordance 44 h,.the provisions of the Plumbing Code of the City of
Cupertino, and h pee haws applicable thereto.
Use of Premises r��/�%�DRel�{^a
V
Owner Ditz Crane Company 2295 De La Cruz Boulevard
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Palm Plumbing Company
L By
J O CONTRACTOR, AGENT
a <245-2323
— w Phone
w z
u f State License 186579
32111 Sunnyvale -Saratoga Road
ess
Approved
PLUMBING INSPECTOR Ll--,'
FIXTURES NUMBER 11 MAIN DRAIN
UNfTSj FEES 11 UNITS I FEES
Bath 'rub
To Curb
Shower /
To Prop. Line ✓
Lavatories
To Existing
Kitchen ink /
Not Conn.
Dish Washer
Sewer Box
Waste Disposal
Size
Softener
Comb.Sink&Tmy To Curb
Dental Unit
Drinkin Fountain
Floor Drain WATER SYSTEM
Hopper I Size
Filter
r fixture r ee
Hain Drain Fee
Storm Drain Fee
Total Fee