657 64 ,A &74't' '^'U LOT NO. "F-I
M NO. STREET
AP,P IL CATIION FOR GAS PERMIT
CITY;;�OF CUPERTINO
24 1959
Date
JUL _ 2 2 1959 t95_=''Yµ Permit No.
.'::is ri •. ,'+:. ..
CITY OF. CJP% f t 10 ='�:' '':_ ` Fees I
y'Q Application is hereby.fnade tathe City of Cupertino fora 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.
v
Use Of.Premises /—
�-a
Owner Address
By DIVISION O Address
)7497 leavens ra ra Clara, CaM. "Approved
Phone w
PLUMBING INSPECTOR
Remarks (Check ✓) .,
4:ypeO'Nppliance Unit sl Fees''l New' .Replace Relocate
, ..�_,.
all Heaters
Circulating,Heaters ,-, I , ."J "I
Blower Furnaces, I. ;/, -:/. d Ii:
Gas Fired'Boilers°'r'„�;,,_
Warmin Ovens 4 "';;• {
' 'Percolators ;;+�^ " �':'•ti "`' l
Griddles
Steam Tables '
Gravity Furnaces
Suspended Unit II.
Floor.Furnace I 1 1I:
II . .
—Miscellaneous '
' NAME TYPE I ' I
I I II I I
I .. I:•' it � �
pp lance .Fees
Inspected_ and Approved .I ..G.-9. . ....... ........
' p TF- � INSPECTOR '
HOUSE GAS PIPING
Number of Outlets I Size of.Main
i Gas Piping Fees '
'Tested and Approved ........................ ..................................`...........
DATE INSPECTOR
o
-GAS' -' E /ICE NQTICS. " OFFICE, .
+r"..l• e. -COPY �5
N '- BUILD G� SPECTOR'S OFFICE r� �` •: ..;
-T PF f
• Y" O J
F Cu RTI I/
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To
You are herebyauthorized to connect the GAS service for
'Owner•or Tenant -. - .. .....
• ri
Z.
"::••. New Service. ........: ................+
No. of Meters ..................::.` Reconnect ...:::. ....:. ...: ..
:,. •
Move'Service
No. of Add. Meters -------------- Move Mite—
..........................
...........................
._. :.
•�
........ ---_. .. ...................................................
LUMBING--INSPECTOR-
tto 6/59-500