1613 A /d7) I // /�0 1�Gia2-!/1 LOT NO.
� NO. r_ST1l9ET{'�r1
('PLICATION Fii R APPLIANCE PERMIT
JAN " 0 19640 QF CUPERTINO
Date �+TIt'!�nz��a�,� �, �/ 3 .1L9<_!z`- Permit No. /_�
U
1 IVI vU�Jt.l( t Fee s: '?t
'9 Application is hereby made to the City of Cupertino for a permit to install
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
of Cupertino, and all other laws applicable thereto.
u
Use of Premises
r7
Ownerr^^"�/ l�e—� 2 �✓ _ Addr /
g -i�,r J �J�o 'T' d Addres�S �• 7•
CONTRACTOR, NT
Phoned u - / Approved
PLUMBING INSPRCTOR
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�i DDITIONAL CHARGE
Ci(f � (� GUP -RTiNO
!�I APR 2 19641L WFNSPECTOR S O=riCe
Date ......-.-........... ._._4—. ._.... . . . ., 7 J...._64 Permit No. ............161 .......-.-..
ll' f F QUPERDN-0Bldg. B-9
To iA _. eat nB,..t,..:uenti�lut4r>i;-..Co,_..........___.._..._...._....____._.
Address .10L7,00..t,...... janjay; `Ave: t -'G-t`E!tnWOOd-CE —€Atli:-'- '
Reason v%1....50...Apgl.ianoe -fee.-.pe.r-2-a.--Ton-..Al,r..Condjt-l-o-rter
4 Unita per bu...... ......_............ . .. . . .......... .......... ..............._.......... ..
6.00
Amount$ ..__........__ RLL «r;p.......
106 3/59-30