1744 //�� V �L+u/'•".-Lc� l!✓ LOT NO. 1 47C L. ,#315o t
NO. 0 STREET Baywood Terr
apIRAPPLIANCE PERMIT
tv �219I OF CUPERTINO
64
Date 5/8/61L '196..... Permit No. /71�1xco __
CITY OF CUPERTI NO Fee a JD-"l
N Application is hereby made to the City of Cupertino for a permit to install
GO
0 gas appliances as listed on the reverse side hereof, and agrees to install said
Happliances in accordance with the provisions of the Plumbing f:ode of the City
of Cupertino, and all other laws applicable thereto.
u
E Res
Use of Premises_�arCt
Dev. Inc. P 0 Box 634
Owner _ Address !:n„a�rrt=nn_
San IrLOS���Sheet Meta or _ naare5s
jj9 CoSanitffi, California 5912605 Approved
O� ` , PLUMBING INSPECT
Remarks (Check ✓) .
Type of Appliance Units Fees II New I Replace Relocate
t,`,as Ranges I I 1
Wall Heaters I I 1
Gas Plates II I I
Circulating Heaters I I II I 1
Blower Furnaces 1 1 1 1 .00 x 1
Gas Fired Boilers 1 I II 1 1
Warming Ovens 1 1 II 1
PercolatdR' 1 j1 1 1
Griddles
i Steam Tables 1 1 11 I 1
Gravity Furnaces I I II I 1
SISp'epded-LJnit 1
—r;eer-i ornate 1 I
Miscellaneous I I NAME TYPE) 1
2 Vents 1 12.001 I
H. tlets I 1 .00
Fee 12.00 1 _
I I II I
I I it I I
Appliance FT- - 1 0-ULf
Inspected and Approved . _.T��.�t�.� ... ...... ..._............... ---------
DATF INSPECTOR