HomeMy WebLinkAboutNO PERMIT NUMBER (3) / �
No. Street Lot No1Gv�
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n
a APPLICATION , LU rM:G PERMIT
U (�1 X00 I'INO @p� 1
San a'iy No.
Ootober 29, �Og T 31 1968
Date , 196_ Permit No.
TY 'I [n p Fee S. 3...5�
s Application is hereby made Itot ChC Ci�'Of C+d@EtOtlhdV�rIA{Ie mit [o install plumbing pipes
and/or Fixtures listed on the reverse side hereof,and agrees to install said prices and/or fixtures
o in accordance with the provisions of the Plumbing Code of the City of Cupertino,and all other
c E laws applicable thereto.
° Dimlling
A h Use of Premises
° w 2295 De La Cruz Boulevard
Owner DitZ Crane Co, Address
By Palm Plumbing Co, na34 Sunnyvale-Sara toga Rd,
3 Contractor,Agent
° Phone 245-2323
ro WILLIR3:. D. P.=NIGH
-� State License 1579 Approved
Plumbing Inspector
FIXTURES NUMBER MAIN DRAIN
Units Fees Units Fees
Water Heater / Size
Water Closet Material
Bath Tub / To Curb
Shower To Prop. Line v
Lavatories To Existing
Kitchen in Not Conn.
Dish Washer
Waste Disposal
Wash Tray STORM DRAINAGE
Washin Machine / Size
Water Softener Material
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 t
ure Fee
Area Drain Drain Fee i
Water Leader m Drain Fee
Sprinkler System er Sys. Fee )
Relief Valve j Gas Fee
Vac Breaker
Skimmer
Filter
Permit Fee i
TotalZ ,&JV Total Fee gyp,.