1607 JA ��
LOT NO.
NO. }STREET
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® A COATIrl..fe't
FOR APPLIANCE PERMIT
#� !JAN '3) 0 1964 CITY OF CUPERTINO
Date_ / , 196 Permit No.
CITY Or CUPERTNO Fres �?e
1� Applicationfis hereby made to the City of Cupertino for a permit to install r
gas appliances as listed on the reverse side hereof, and agrees to install said
appliances in accordance with the provisions of the Plumbing rode of the City
U of Cupertino, and all other laws applicable thereto.
Use of Premises— 44
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bi Owner _ Addr
By— Addres S _
CONTRAC/TOR, AGEN
Phone U a Approved
PLUMBING INSPECTOR
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(ARR;�2 196
HUILDING INSPFC I'OR'5 OF@ICF,
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Address, _„.39.7.Q.0. N..----131aney.,...QreenW9od_:'Ct.?...Apts....:Alk.'.p.;-.3. '.,
Reason $1 50., charge per, unit , for appliance fee for,.3
Air Conditioners. (4 Unite per)Building). 2 Ton Vni.;�t
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