1395u
NO.
1AUG 27 9963
LOT NO
APPLIANCE PERMIT
OF CUPERTINO
Date:q �' •.i 196:3
! VI U.
I
Permit No. J 2
Feet • �
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 slid
appliances in accordance with the provisions of the Plumbing code of the City
of Cupertino, and all other laws applicable thereto.
Use of
/ __ o/,111
yw o L�,uotr
Address
Ad
Approv
PLONa1NG rNSPBCTOa
Type of Appliance I Units Fees II
Remarks (Check ✓)
New Replace Relocate
Gas Ranges
\r/all Heaters
Gas Plates � ��
Circulating Heaters
Blower Furnaces
Gas Fired Boilers
Warming Ovens
Percolators
Griddles
Steam Tables
Gravity Furnaces
—jr
Suspended Unit
All
Floor Furnace
Miscellaneous
NAME. TYPE)
P4 sante Fees
(�—
mspecreu and nppruvcu ..... /—*— ..r.......
DATE. INSPECTOR