493 (7�U� � � -.-✓ r�-��LC�.-iJ LM NO. �P-
NO. S Y
® R APPLIANCE PERMIT
f M 2 6 1961 / OF CUPERTINO
Date Y 196..1 Permit No.
CITY OF UPERTI Fee$ ! '
Application is hereby made to the City.of:Cupertino for a permit to install
gas appliances as listed on the reverse side'heieof, and agrees to install said
appliances in accordance with the provisions of the Plumbing rode of the City
of Cupertino, and all other laws applicable thereto.
_.1
Use of Premises Ail ,
Owner �� � �0�' �' �Address
t �
,80
t By .Address
NTBACTOa, AGENT
HEATING & SHEET METAL CO. Approved
80E S{Pi�. MPBELL, CALIF, - PLUMBING INSPECT
Remarks ( eck ✓)
Type of Appliance I Units Fees II New I Replace Relocate
Gas Ranges I t
Wall Heaters I I a I I I
—Gas Plates I I I I
Circulating Heaters I I II I I
Blower Furnaces
Gas Fired Boilers I ��
Warming Ovens
Percolators
Griddles I III I I
Steam Tables I I_ I
Gravity Furnaces I �r II_ I �_
Suspended Unit I
Floor Furnace
Miscellaneous I � �� iIR�•'
NAME TYPE
° � r
I I III I
II I III I��_
pp I lance Fees
Inspected and Approved ......__.._. ... ...............................
DATE. "t. INSPECTOR