1586 LOT NO. f�Q
����No, A STREET
VAPPLICATIION1 tF,,6 APPLIANCE PERMIT
DEC 9 1963 kkC,rY OF CUPERTINO
Date•r`4 DCC r ^r' 196.3. Permit No.
t 11 I C ren y�
Co Fee $—p 0
00 Application is hereby made to the City of Cupertino for a permit to install
O
r-1
rgas appliances as'listed on the reverse side hereof, and agrees to install said
appliances in accordance with the provisions of the Plumbing r:ode of the City
y of Cupertino, and all other laws applicable thereto.
2
Use of Premises Re_a
Ward Crump Dev P.O. Box 634
n Owner Address _
By an Carlos Sht Mtl . Address 779 Old County RD
CONTRACTOR, AGENT S. C.
Phone 591-2605 1 Approved
PLUMBING INSPECTOR
Remarks (Check ✓)
Type of Appliance I Units Fees II New I Replace Relocate
Gas Ranges 1
Wall Heaters 1 II I
Gas Plates I I 11 I
Circulating Heaters I I
Blower Furnaces 1 1.00 xx I I
Gas Fired Boilers I I 11 1 1
,Warming Ovens 1 1 II I
•Percolators I I I
Griddles
Steam Tables I
Gravity Furnaces
Suspended Unit_JL II 11
_Floor Furnace 1 I
1
.Miscellaneous ii 1
(NAME TYPE) --F--717
11 1
•. Fee I
Outle s 121 1 3.0011 1
Comb Vent I _nnll _
1 I II 1
Appliance Fees .0 I
Inspected and Approved .t.- .; - .,._ " .yam.._.............._......
BATF. 1 INSPECTOR