51167.2LOT NO.
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APPLICATION FOR PLUMBING PERMIT
z < CITi OF CIi Pf:RTINO v///
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��r � V Ahfirlhation is hereby made to lhr City- of Cuhcttin„ for .r Permit In mstojl plumhin>,
1 Pipe; Jnr{r'livttv Bite t rt; the nscrsc pit. litrenf d ., •. e,s In tint t! ,e '1 p,
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r m I/ur fixtures InatL.51.) :::. l,m� t.: ni tt i C Icmbi•i,l !tc t, ty if
a w Cupertino, -and all other lank al -t ai .t1>Ic t[:crrt0. - - - -
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Duelling _
�. Use of Premises ......
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Owner--Mz Crane Company---- �?P$,De-La-Cruz Boulevard
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By. Palm Plumbing CoMany____ 1$34,!Sunny-v_ale�aratoga-Road
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— Phone_245-2323-------
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FIXTURES
NUMBER
MAIN DRAIN
Fixture Fee
UNITS FEES
UNITS FEES
Water Beater
Storm Drain Fee
Size
Water Closet
.71 1
Material /
Bath Tub
To Curb
Shower
/
To Prop. Line
Lavatories
To Existine
Washer
Machine
_Comb.Sink & Tray 'l'o Curb
Dental Unit
Floor Drain I 1 11 WATER SYSTEM
Sand Trap
'TOTAL FEES
Urinal
Fixture Fee
Area Drain
Main Drain Fee
Water Leader
Storm Drain Fee
Sprinkler Valve
Water Sys. Fee
Relief Valve
Gas Fee
Vac Breaker
Skimmer
_
Filter
Permit Fee
Total
1,YST Total Fee aid