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362 10.3&,91 � � > �� LOT NO. moi, r .NO. STREET � O TOR APPLIANCE PERMIT N OF CUPERTINO l pjJAN / Date w 196---- Permit No._ b Z l� CITY OF CUPERTINO Fee $ l 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 r'.ode of the City of Cupertino, and all other laws applicabl thereto. I Use of Premi— v h Owner _ Address & Address Cr NTMCTORr ENT ' ,(SCG[ Phone E 'c�! / Approve PLUMBING INSPECTOR Remarks (Check 0 Type of Appliance I Units Fees II New Replace Relocate Gas Ranges Gas Plates Circulating Heaters Blower Furnaces Gas Fired Boilers Warming Ovens Percolators Griddles Steam Tables Gravity Furnaces Floor Furnace U Floor Furnace _ Miscellaneous � ii (NAME TYPE) I I� pp lance Fees ��— Inspected and Approved 2. %/, ...... .......................... DATE. INSPECTOR GAS SERVICE NOTICE OFFICE COPY �/ BUILDING INSPECTOR'S OFFICE CITY OF CUPERTINO ..........................71."?l........................... 196...... To You are hereby authorized to connect the GAS service for Owner jor Tenant .....al .. . ............................ At... . . . ............ .................................................. New Service ................. No. of Meters ..../................. Reconnect .............................. Move Service ........................ No. of Add. Meters .............. Move Meter .......................... ...............�W� LUMBING INSPECTOR 110 1/60-500