51167/IOOT I [z .A't't'r' LOT NO.�L
O S1T11�F.F.T,,
A u1G'A ON FOR PLUMBING PERMIT
Y OP CUPERTINO
MAY 27 966 sanitary No.
�I I 19(i< Permit No ��� 7
I I OF Pee $ O 0
Application is h�e'6P11A Q) 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 in accordance with the provisions of the Plumbing Code of the City of
Cupertino, and all other laws applicable thereto.
Use of Premises Dwell ing
Owner Ditz-Crane CO Address P_ 0_ Bme 509San .Tnag
By Palm P1 inn 00.. Address 12311 N AWY 9 -Sunnyvale
CONTRACT R, AGENT
Phone 2115-2323
State License 186579 Approved /
/I PLUMBING INSPECTOR
`Plater Heate
/-d
ler
Fee
RECORD OF INSPECTION
Underground Rough
Partial Rough
Rough. Complete
Main Drain
Final .