1621 � � Tract f 3 3150
LOT NO. Lot113
NO. STREET
AP lCi4 d `R APPLIANCE PERMIT
C OF CUPERTINO
3 e(FEB 10 1964 „ ; 4
Date 196..... Permit No. //' `
CITY OF CUPERT.�' Fees ?, o C)
Application is hereby made to the City of Cupertino for a permit to install
GO gas appliances as listed on the reverse side hereof, 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.
Use of Premises Res
Owner Ward Crump Dev. Inc. Address P.O. Box 634
S* Carlos Slat Mtl Wks. Aak Addres?7900 d County Rd. S. C.
CONTR CTOR, AGENT /J
Phone 591-2605 Approved c//J
,�7 _ PLUMBING INSPECTOR
Remarks (Check J)
Type of Appliance I Units Fees II New I Replace Relocate
Gas Ranges I I
R1sll Heaters
Gas Plates II
Circulating Heaters
Blower Furnaces p..00
Gas Fired Boilers 1 I 11 I 1
Warming Ovens I I 11 1 1
Percolators fl I I
Griddles I 1 11 1 1
Steam Tables 1 1 1
Gravity Furnaces 1
Suspended Unit
Floor Furnace I 1 11 1
Miscellaneous 1 1 it 1
` (NAME TYPE) I 1
Fee 2—rC .O�
ou 1 . 3.00
W H vent 1.01
Ht vent dl I
pp lance Fees ��—
Inspected and Approve ... . ... ... ............... ...
...........
DA P. INSPECTOR