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2618 lel7z 112 ' ��I7O.0 (iG'G'� Ci LOT NO, - I NOVINOV8 srEE N APPL•IGATI� N FOR GAS PERMIT CF CUPERTINO xo 1963 � ' 3 U Date �� 19f>,� Permit N0. = LL CITY OF CUPERTIM Fee $ E �© O Application is hereby made to the City of Cupertino for a permit to install gas pipes 'o a and/or gas appliances as listed on the reverse side hereof, and agrees to install said pipes i N and/or appliances in accordance with the provisions of the Plumbing Code of the City ar of Cupertino, and al of er lawsapplicablethereto. 0 0 �se f P2remi es r > 0 b%f oa Own`er/ ,// /'JAddress Ru� J z Bu.� -e!. I Address 2 O CONTRA x, AGENT o a State License yr�� a < o Approved G d U t x Remarks (Check ✓) Type of Appliance Units Fees II New Replace Relocate Gas Ranges Wall Heaters Gas Plates Circulating Heaters Blower Furnaces Gas Fired Boilers Warming Ovens Percolators Griddles Steam Tables Gravity Furnaces Suspended Unit Floor Furnace Miscellaneous .(NAME. TYPE) it HOUSE GAS PIPING - Number of Outlets Size of am Gas Piping Fees Tested and Approved k. ....�.....1 t%t<� ............._.... '... ATE ` INSPECTOR II -