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No. Street Lot No.
APPLICATION FOR PLUMBING PERMIT
CITY OF CUPERTINO
1• Sanitary No. ODA- Box
Date �� " , 196z-e"Permit No..��i
V
+nre Fee .id
�_
Application is hereby made to the City of-Cupertlno for,a•�perma-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 Dwelling
Ditz Crane Company 225 De La Cruz Boulevard
Owner Ad ress
By Palm Plumbing Company
Contractor, Agent
Phone 245-2323
186579
State License
V ✓
Xg&Sunnyvale-Sara toga Rd
Approved a^ J
Plumbing Inspector //
Water Heater I / 1 II Size I i- I
Water Softener I 1 II Material I I
COmb.Sink & Tray �� To Curb
5e12_
eUnit
Restaurant Sink I 1 II Material I I
Total