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10981 ZOOda LOT NO. Iwo. smBET (�p /? '4 i SEP 1-MI y ON FOR Wim PER T Aj--- - aS� r ^Ct OF CUPERTINO D C1T . FCU ' 1I\�195— Permit No. M Fees Application is hereby made to the City of Cupertino fora permit to install gas pipes and/or gas appliances as listed on the reverse side hereof, and agrees to install said pipes and/or appliances in accordance with the provisions of the Plumbing Code of the City of Cupertino, and all other laws applicable thereto. y :4 Use of Premises A Owner W im"^-'-' Address By Address r -.2.c fONTRACTOR, AGENT ' Phone 'L _ Approv -- PLUMBING INSP OR Remarks (Check ✓) Type of Appliance Units Fees.11 New IReplace Relocate Gas RangesI Wall Heaters I I Gas•Plates I I I I I Circulating Heaters II I Blower Furnaces �lil� Gas Fired Boiler I I I Warming Ovens Percolators. Griddles I I II I I Steam Tables 1 Gravity Furnaces spended SuUnit II I I• •_ Floor Furnace I II II I II I Miscellaneous ) I I NAME TYPO -�-_ 11 III I I k Ji I i II I I pp lance Fees — Inspected and Approved .......... ...: ..I................................................ DATE. INSPECTOR HOUSE GAS PIPING Number of Outlets I Size Of Main Gas�Pip;ng Fees T .� . . ..U7�...1..... ............................. ted and Approved ATR INSPECTOR GAS SERVICE­NOTICE OFFICE COPY BUILDING INSPECTOR'S or"ma. CITY OF CUPFRTINNO ................................ 196.1 .......... ...... To I You are hereby authorized to conne Ile GAS Service for Owner or Tenant -dam 0 ............................... At ----A .7.. ... . . ... ...... . ..................................................... New Service .......................... No. of Meters .....�............... Reconnect .............................. Move Service ........................ No. of Add. Meters .............. Move Meter .......................... I! ............. ....................7 PLUMBING INSPECTOR ito 1/60-500