51187LOT
NO.
[IAPPLICIAXION�FOR�PLUMBING PERMIT
CITY O�' C" PERTINO
/JUN 12 1968 48 Sanitary No. v' 701
Date_ June 10, 196 Permit No S
:TY OF CUPERTINO Pee 523"T
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
Ditz Crane Co.
By Palm Plumbing Co.
CONTRACTOR, AGENT
245-2323
State License 186579
��2k,,De La Cruz Blvd.
134 Sunnyvale -Saratoga Rd.
ress
WILLIAM D. SEN£VICH
PLUMBING INSPECTOR `'
FIXTURES I
NUMBER
MAIN DRAIN
UNITS FEES
UNITS FEES
Water Heater
/
Size
Wal. --r Closet
Z
Material �.
Bath Tub
/
To Curb
Shower
/
To Pro . Line
Lavatories
To Existing
Kitchen Sink
Not Conn.
Dish Washer
Sewer Box
Waste Disposal
Wash Tray
STORM DRAINAGE
Washing 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
Fixture Fee
Area Drain
Main Drain Fee
Water Leader
Storm Drain Fee
Sprinkler Valve
Water Svs. Fee Ii
Permit Fee
Total Fee