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287 L A _C�G S��A •`- LOT NO. NO. ggFF STREET NOV A 1PL AT1 - FOR APPLIANCE PERMIT !+ 7V n ftOF CUPERTINO 1_iDate � � 6..... Permit No.�.� So �/ (�F (+�� [p�'n'n Fee Lidri1is heiLtb'FIkddel ttl iQ City of Cupert no 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 ws applicable thereto. u G Use of Prem' es ui Owner �J _ Address By 2 1 M - 1- Address G AN L .� coNTancroa, AGE"Phone APProv PLUMBING INSPECTOR Remarks (Check ✓) Type of Appliance I Units Fees II New Replace Relocate Gas Ranges Wall Heaters Gas Plates I I JI-41 _ Circulating Heaters 11 Blower Furnaces II L Gas Fired Boilers II Warming Ovens �� Percolators Griddles Steam Tables Gravity Furnaces Suspended Unit Floor Furnace Miscellaneous ftl (NAME. TYPE) pp 11ance Tees Inspected and Approved ..................;......................................... ...... DATP. INSPECTOR GAS SERVIPE .NOTICE .0HICE 'd Co�y BUILDING INSPECTOR'S OFFICE �a 49� CITY OF CU TINOrq ..................................................................... 196A... TO You are h -e orized to connect t G service for Owner or Tenant .................................... %k� ................................. At.........t...t�3.. ............................. New Service .......Y................. No. of Meters ....._L.._.......... Reconnect .............................. Move Service ........................ No. of Add. Meters .............. eter .......................... ............... . 1� PLUMBING INSPECTOR 110 110 1/60.500