117 /•OI✓� I"C� ,_. .. _ LOT NO.
• NO. STREET
nnLYWIQX FOR APPLIANCE PERMIT
Dex%-NI F CUPERTINO
Date2049636----- Permit No.
�; TT�� ((��FF (/�.11!! [��� Fee S /g `
r p'plitatiiQF hEtFdl$mltlTt �City of Cupertino for a perin'irto.install y -
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 Cifq'..
of Cupertino, and all other laws apP,iicable thereto.
Use of Premises
I'li � � � Address
—DIV "% a'
By HEATING a ..r; Add[ s
HO E. SUNNI. PMPPhARfiW£L, CA.
Phone
% _ PLUNEING INSP8G70R yr
Remarks-7f(Ch'eck ✓)
Type of Appliance I Units Fees II New (lRe Relocate
Gas Ranges
Wall-Heaters
Gas Plates; I 1 11 44
Circulating Heaters I • I 11 ,I11
Blower Furnaces / I(,moo 11 ' ■�
Gas Boilers I II
Warming,Ovens I
Percolators'
Griddles
Steam Tables
Gravity Furnaces IF 11_
' Suspended Unit I - I II
Floor Furnace 11
Miscellaneous
NAME TYPE)
II
I I IIS. I
I I slim II
PP+ante
Inspected and Approved . .. ..2 ..: c- --
DA P. jf INSPi TOR
i t
,
GAS SERVICE -NOTICE C;FFICE
I BUILDING INSPECTOR'S OFFICE COdh
CITY OF CUPERTINO
................. . /.. z.................. ...., 19. 0
To
You are hereby authorized to connect the GAS serv' for
Owner or Tenant
�1....a---�/liC/...... / ..��/�,Qi-iO:........::.. ...
At �.�..1!r .L�........I----Z...:...
...:.:..
New Service .......... ...........
• No. of
Meters,
.: ---- Rec.
. a 7'!_
Z% Move Service•........................
:x-',,
No:of Add. Meters ...........:.r ' .+„', . _ Move Meter Fr....._.:......,.........;
Id PLUMBING�INSPECTOR '