NO PERMIT NUMBER r j
o No. et q_ Lo[No
y FJw(A �1
APP' i�' CITY OF CUPER N FOR PLUMBING
ING PERMIT
E NOV 19 1968
Sanitary No.
:November
Ifl
E ate; t �" f:: rnT!° V,196_ Permit No.
3 Fee s,?3,sZJ
r 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
0 in accordance with the provisions of the Plumbing Code of the City of Cupertino,and all other
laws applicable thereto.
0
1781 Ti nrop
Use of Premises
' Ditz Crane Company 2295 De La Cruz Boulevard
' o Owner Address
By Pal* Plumbing Company 223hs�unnyvale-Saratoga Rd.
3 Contractor,Agent
ami Phone 245-2323
186579 WILLIAM D. SENIMV!,r'!
-� State License Appfbved
V Plumbing Inspector
FIXTURES NUMBER MAIN DRAIN
Units Fees UnitFees
Water Heater Size IV
Water Closet Material
Bath Tub To Curb
Shower / To Prov. Line
Lavatories To Existing
Kitchen ink Not Conn.
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 kFixture
YSTEM
Hopper
Restaurant Sink
Sand TrapAL FEES
Urinal e Area Drain Fee /Water Lea er in FeeSprinkler System Fee
Relief Valve I Gas Fee
f�
Vac Breaker
Skimmer
Filter
Permit Fee
Total .3 Total Fee 2 3