275 LM NO. M
Nou—f a'7XUTJ
■AVVIIP�IF_ LAAPPLIANCE PERMIT
�ic4 C • F CUPERTINO
,p Date PITd OZ01PERT11110G..__- Permit No. S'
Fee S
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
4 of Cupertino, and all other laws applicable thereto.
e
Use of Premises Res .
r7i Owner R nLLs P ALL QPM-, Address 1 •F
'. .
SAN CAB SHEET METAL WORKS, INC. Address
OLD COLO RYa.pfl0r0 AGBNr
QQIiOnEeRI nS CALIFORNIA # Approve
iP1ULBING WBPB
-.x
d
Remarks (Check ✓1
rT pe of ApplianceI Units',Fees II ,New Replace Relocatb
Gas'"Ranges
'sWall Heaters
Gas'iFlates
iii Cirailating Heaters VTI-r., 11 -�+-�
Blower Furnaces "r
Gas Fired Boilers
Warming Ovens LI
Percolators —11k—
Griddles
S eamVTables
te Gravity__Furnaces
"'>..Suspended Unit � � II
' Floor Furnace
Miscellaneous
(NAME TYPE)
pp lance ees . �—
Inspected and Approved ... .. .. .'..... ...._......_........
'I D1TF. INSPECTOR