652 / C 6 70 41 /l�'ZS.� Z14 ` _ LOT NO.
NO. STREET
APPLICATION FOR GAS PERMIT
LCITYOF CUPERTINO
JULj241959 . =r
\ Date J U l 2 2 1450- 195_ Permit No. �
CITY Q7 CUPERTINO Fee$-
Application is hereby made to the 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
1.4 and/or appliances in accordance with the provisions of the Plumbing Code of the City
of Cupertino, and all other laws applicable thereto.
u �
Use of Premises
05 Owner &C Address
BDIVISION naaress
y C ,co.
V497 Stevens Geek Rd, Fanta Clara, CaM. Approved
Phone
P BING INSPECTOR
Remarks (Check ✓)
Type of Appliance Units Fees II New I Replace J'Relocate
Gas Ranges
mall Heaters
Gas Plates
Circulating Heaters
Blower Furnaces / f Xo �� ✓
Gas Fired Boilers
Warming Ovens
Percolators
Griddles
Steam Tables
Gravity Furnaces
Suspended Unit II
Floor Furnace
Miscellaneous � �. it � � i
-` (NAME TYPE)
Appliance Fees
Inspected and Approved ..... ..
rt DATF INSPECTOR
HOUSE GAS PIPING
Number oPOutlets Size of Main
Gas Piping Fees
Tested and Approved ......... ....... ...............................................
DATE INSPECTOR
OFFICE
ELECTRIC S
ERVIC
.�'TICE-7-
C
BUILDING 14P TdR S' �Fl E
GIT PfRVTO
.................. .............. ------
To IV,
You are hereby authorized to connect the(�Iectric servi C' for
Owner or Tena,et..J;�?15-�-r...`/
. .. ............. ;�......
10 Je
1:0
...... . ......... ........... ...... ......... . - ------
Al
No. of Wires ... ................ ----- Size of Wires .......:2........ Size of Switch� --------
MotorLoad ---------------------------- Voltage ................................ Phase....................................
Heating Load ........................ K. W. ...... ........ .......
Volth
No. of Meter Li
9 t......... ---- 114 :New Service................. Reconnect....--..-_.......
Heat............. .. 22 Three Wire------------------- Move Service............
No. of Add. Meters_...._...-i
po,,erThirey Phase..-_............. Move Meter..............
I
104 2/59-250 !i 5�*4�� ......................... ..........
TRICAL INSPECTOR