51167.2I"� ��J<I� LOT NO. �ciJ
NO. STREET
APPLICATION FOR PLUMBING PERMIT
CITY OF CUPERTINO
3U m'J(I�
o lication is h w9�de
`o a p' akd/ �ixtures liste`� o
P' fixi�res ynf+fcordancc
a w Cupertino, and SdCMtft w:
Sanitary No. "5—?8 /
1 1968 Permit No 51(4 % •�
I,� Fee S 2 L "
bb"%City of Cupertino for a permit to install plumbing
& ,everse side hereof, and agrees to install said prices
+mh the provisions of the Plumbing Code of the City of
applicable thereto.
� r
LL Use of Premises
0 0 ?A2d9dn De La Cruz Boulevard
'" Ditz Crane Co
3 Owner Comp rens
Oa
zj z B Palm Plumbing Company 3A um vale -Saratoga Road
J O y CONTRACTOR, AGENT
3< Phony 245-2323
— �
wz
w w 186 79
a LL 5 Approved /
a a�State License
PLUMBI x INSPECTOR /�
FIXTURES I NUMBER 11 MAIN DRAIN
UNITS1 FEES 11 UNITS I FEES
Shower
To Pro . Line
Lavatories
To Fxistin
Kitchen $ink /
Not Conn.
Dish Washer
Sewer Box
Waste Disposal
Washing Machine Size
Water Softener Material
Bar Sink To Main Drain
Comb.Sink&Tray To Curb
FloorD ain WATER SYSTEM
Hopper $i ze
Area Drain
main Drain Fee
Water Leader
Stoma Drain Fee
$ rinkler Valve
Water Sys. Fee ��Q
Relief Valve
11 Gas Fee I /f
Filter
Total /I I/bd plj Total Fee I ,?/ S7J J