466 LOT NO.
NO. STREET /f
.APPLICATION FOR GAS PERMIT
CITY OF CUPERTINO
Date 1 5 Permit No.
(MAY 7 1959 Fee $ ` �
Application is hereby made to the City of Cupertino fora permit to install gas pipes
and/or ga ffric�`as I t P�� f (( a side hereof, and agrees to install said pipes
- and/or app lances in acco``r�dance wit t}}�I,,e provisions of the Plumbing Code of the City
of Cupertino, and all other laws applicable thereto.
c
Use of Premisese�o
w . 'Owner . , 0�> -��ddress
�ByV' . L. ~ItCONTRACif'ORIvwfiNllfJ y.l Address -�=_4L
J—
Phone P. O. Box 578 11 Approved rr� L✓
PLUMBING INSPECTOR 5 BCTOR
t Sunnyvale, VBIIL.
f Remarks (Check ✓) .
Type of Appliance Units Fees II New Replace Relocate
Gas Ranges
Wall Heaters -
Gas Plates 1 II
Circulating Heaters
Blower Furnaces
Gas Fired BoilersI
Warming.Ovens
Percolators ,
Griddles
Steam Tables
Gravity Furnaces �I
Suspended Unit II
Floor Furnace - .3
II
Miscellaneous it i
I I
(NAME'TYPE)
I I II I I
I I II I I
I I II I I
app I�Fees
Inspected and Approved ........ .....:... ......___...........�...................
DATE. INSPECTOR
HOUSE GAS PIPING
Number of Outlets Size of Main .
Gas Piping Fees /
Tested and Approved
DATE INSPECTOR
R % _
GAS SERVICE 'NOTIC� OrrICF
COPY
BUILDING INSPECTOR'S 04iCE
CITY OF CUPERTIN6� "
----------- ...................... .:------ .0-7 .7.......... 1�s'
To
You are hereby authorized to connect the GAS service for
Owner.or Tenant ---- r.R/L/K/..... .... d`.`�7.. - .tea........---.........
New Services.. ,
No. of Meters .................. ... Reconnect ..... ......:...........- j,
Move Service .: . ...............
No. of Add. Meters .............:. Move Meter ....�.........:..........
UMPING INSPECTOR
ito 6/59-son