LOT 32Z:?'� [/ LOT NO.
NO. STREET
_ APPLICATION FOR PLUMBING PERMIT
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Date�I��ll22AA
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o a October 8, I Per i 'o
3
U 196
' 10 C T 14 t Pee $ 3. 5
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� Application is hereby made to the City of Cupertino for a permit to install plumbing
o a pipes and/or fixtures listed < tltK�rer f and agrees to install said prices
> and/or fixtures in accordanc iwitH the,p ov tz' P TR"'
�i nbing Code of the City of
a w Cupertino, and all other laws applicable thereto.
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Dwelling
ng
Use of Premises
Ditz Crane Company 2295 De La Cruz Boulevard
3 Owner ' Address
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z By Palm Plumbing Company d3 Sunnyvale -Saratoga Rd,
O CONTRACTOR, AGENT
3 <245-232 3
— W Phone
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a o State License 186579 Approved lnm ....,.. /4
—I" ,�/ PLUMBING INSPECTOR V
Total I 7 I/�Sa II Total Fee
FIXTURES
NUMBER
MAIN DRAIN
UNITS FEES
UNITS FEES
Water Hewer
Water Closet
o7"
Material C/
Bath 'Cub
/
_
To Curb
Shower
/
To Prop. Line
Lavatories
Existing
Kitchen ink
/
Dish Washer
Waste Disposal
RConn.
Wash Tra
INAGI
Washin Machine
/
Water Softener
Bar Sink
To Main Drain
Comb.Sink & Tray
To Curb
Dental Unit
Drinking Fountain
Floor Drain
WATER SYSTEM
Hopper
Size
Restaurant Sink
Material
Sand Trap
TOTAL FEES
Urinal
Fixture Fee
Area Drain
Main Drain Fee S02t
Water Leader
Storm Drain Fee
Sprinkler Valve
Water Sys. Fee /
Relief Valve
Gas Fee
Vac Breaker
Skimmer
Filter
Permit Fee
Total I 7 I/�Sa II Total Fee