119 20 076aLOT N.rp. O J. 6 11
'NG. STREET
pf'�
PLI�ATION IFQR APPLIANCE PERMIT
OF CUPERTINO
AR 251960
Date MAR 2 2 1Qfi0 196..... Permit No.-40—__
v'TY CF CUPERTINO Fees
Application is hereby made to the City of Cupertino for a permit to install
gas appliances as listed on the reverse side hereof, and agrees to install said
appliances in accordance with the provisions of the Plumbing rode of the City
of Cupertino, and all other laws applicable thereto.
Use of Premises K
Owner° DIVISION
Address _
By „E.r,. r ..ter., Address
180 E. SUN NYMTPtC °Q2, CAL App
ro one Xro
_ PLUMBING INSP8CT00. �
"}� Remarks (Check ✓)
Type of Appliance I Units Fees II New Replace Relocate
Gas Ranges
\V I Heaters
Gas Plates
!l Circulating Heaters �:,,;;'_"�&� . • ��
f Blower Furnacesdill
Gas, Fired Boilers
armingarming10vens
Percolators_F
to
"STspen de'dlUnit -r
Ftoo]FStn a
'Miscellaneous
If NAME TYPE) I I�
e• "lig � I � I '
pp lance Fees 0.
.l• �Nsrecroa
�., nspttted and Appro'ved�a.�17.. ... . - ECTo.=.'............
'
DATE � �Yry
+i J
GAS SERVti �� pTiCE ' {: � . a PCE
-+ �IIUILDING�IN ,� RS OFFICE, -. '•'� ;'i,:
CITY OF'CI9PERPI
8
To
:
r
" You are hereby authorized,to conned the GAS service for `
41,
Owner or Tenant ... .C ---K�l�C�:...:..- -a--`...... r..:...:..
t7
New Servic —"�;"
. ........
.. , No. of Meters ..... ............... Reconnect :w " f;P F
r'
oveOxOx__rvite .. :..,
._4,
�.r
` No. of Add. Meters .---....._:.. k %Mo've Me ter ..:........:..........
...-----_..... .................----.........:. .;. ............
PLUMBING INSPECTOR
A;110 6/59-500 . . f �•