561 Sp9 . ,?o/�✓ 3v
COT NO.
APFOR APPLIANCE PERMIT.
f1p
I OF CUPERTINO
Da 196...
96... Permit N. o. JSai
Fee f
CIA;Ylicafil DARDOhe
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 bode of the City
of Cupertino, and all other laws applicable'thereto.
Use of Premises
7;3�piwner4° _ Address ti
ByAaaress
ATING & Bf1fifiTAA4J LAcD6rP,
Qf- 1*69uNNYUMS AVE., CAMPBELL,'CALIF. Approve
PLUMBING INSPB a '
Remarks (Check ✓)
Type of Appliance I Units. Fees II New Replace I Relocate
Gas-Ranges
Wall Heaters
Gas, Plates �I
Circulating Heaters
Blower Furnaces
Gas Fired Boilers 1
Warming Ovens
Percolators I jl_ I
Griddles I I II I
Steam Tables
Gravity Furnaces
Suspended Unit
Floor Furnace
Miscellaneous
NAME TYPE)
I I II I
I I
I I I
I I II I
I I II I�L
pp lance 1 ees I S I II
Inspected and Approved .��_ ?.. . ...... ..........
DATE INSPECTOR
1
GAS SERVICE' NOTICE OFFICE
COPY
BUILDING INSPE'CTOR'S OFFICE
CITY OF CUPERTINO
.........................A&............ ......... 196---
To
You are hereby authori d to connect the GAS service for
O
Owner or Tenant -------- . .. . .... ... ...........
.... - ------------- ..........................................................
At ......
New Service .....i..............
..........
No. of Meters ......4------ --- Reconnect . ............................
I ,\ I — Move Service ........................
No. of Add. Meters .............. Move Meter ..........................
r.
............. . .. .......... .........................
.N-1 PLUMBING INSPECTOR
110 1/60-500 PLUM