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2054 i V 1 Zl©.I l ►T LOT NO. NO. STREET t0 ® � t_ , TION FOR GAS PERMIT CITY OF CUPERTINO OCT 10 1962 Date I e'-' 9 19`z Permit No. CITY OF..CURERTINO Fee $_3, pro l Application is hereby made to the,City of Cupertino for a 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. n n Use of Premises_'m - a"' ` � � � '.: •. = i h Owne7 Address ERN LI. BUCKLE PLUMRINrc, roAft Address 1401,9 9�y -sin %Vav CONTRA&QR A P ' ` 5 N3Tifornia Phone —3 4/7Approved T, PLUMBING INSPEC Remarks (Check d) ;Type of Appliance I Units Fees II New I Replace I Relocate �;as Ranges .. Wall Heaters Gas Plates I � I I I `� Circulating Heaters I I II I Blower Furnaces Gas Fired Boilers I �� Warming Ovens I �� Percolators Griddles Steam Tables, I I Gravity Furnaces I I l Suspended'Uriit Floor Furnace I _ Miscellaneous NAME TYPE) I II I I I III I II .- I I I I I PP lance Fees I II Inspected and Approved ..............:_.I......_.......... DATE. INSPEC�TgQR( HOUSE GAS PIPING Number of Outlets I ✓� I Size of Main 7 " Gas Piping Fees I J, D — In Tested and Approved 3.....I... .......................... DATE INSPECTOR 74- O)W- to o C2" z � ; p � g Vim . to