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1619 n /� Tract #3150 r1 4 ! r_b>% J'r�� Lot #111 BT, LOT NO. NO.- ih F LT'tCt lP6%Ne 4 R PPLIANCE PERMIT C OF CUPERTINO 3 F@@h. �in4 Date GIT . I1pFR 1,.1W... Permit No. Fee= 0 y Go Application is hereby made to the City of Cupertino for a permit to install C\1 gas appliances as listed on the reverse side hereof, and agrees to install said 0 appliances in accordance with the provisions of the Plumbing rode of the City of Cupertino, and all other laws applicable thereto. u E Use of Premises Res Ward Cramp Dev. Inc. P. 0. Boa 6k 634 ig OwnerAddress Sar YCarlos Sht tftl Wks. Addres779 0 County Rd. S. C. CONTRACTOR, AG BNT � � Phone 591-260$ Approve PLUMBING INSPECTOR Remarks (Check ✓) Type of Appliance I Units Fees II New Replace I Relocate Gas Ranges 1 II 1 Wall Heaters I I I 1 Gas Plates Circulating Heaters I I 1 Blower Furnaces 1 1 11.00 II Gas Fired Boilers Warming Ovens 1 Percolators 1 1 11 1 1 Griddles 1 Steam Tables I 1 11 1 1 Gravity Furnaces ' Suspended Unit 1 1 II Floor Furnace. I I II I ;Miscellaneous 1 1 (NAME TYPE) I Fee 1 1 2.0011 xmdz 12 out. 1 13-0011 w.h. vent 1 11.0011 _ . ven 1 11.0011 r pp lance Fees �— Inspected and Approved nom. .. .. .........r. .`.......—....._.._........ ATF. INSPECTOR