HomeMy WebLinkAboutNO PERMIT NUMBER (3)LOT NO.
NO. ST F. F.a' D
APPLI AT PERMIT
f l/-tYT 0 C ng,TI O� li
Sam . ry No.
Date September _ (J'�8 Permit No
�'� i lir �UPERTWO Pee S_ o
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 in accordance with the provisions of the Plumbing Code of the City of
Cupertino, and all other laws applicable thereto.
Use of Premises
OwnAtz Crane Compal
Dwelling
B Palm Plumbing Company
By CONTRACTOR,AGENT
245-2323
State License 186579
2 5 DeRU Cruz Boulevard
A dress
Sunnyvale -Saratoga Rd.
r S5
Approved
PLUMBING INSPECTOR
4l.J
FIXTURES NUMBER �� MAIN DRAIN
UNITS FEES UNITS I FF.F.S
L
Shower
Kitchen ink / Not Conn.
Dish Washer Sewer Box
Waste Disposal
Machine
Comb.Sink&Tray I 1 11 To Curb
Floor Drain �� WATER SYSTEM
Hopper Size
Main
Valve
TOTAL
Permit Fee , aQti
Total Gf /� f Total Fee