322 LOT NO. -
NO. STREET ,
2 1 S APPLICATION FOR GAS PERMIT -�
CITY OF CUPERTINO
Date , 9 !r[. Permit No.
APR 101959 Fee $ /
Application is hereby made to the City of Cupertino for a permit to install gas pipes,
and/or%TYP liGFs is 1i�2ERTI Merse side hereof, and agrees to install Said pipes-
\ and/or appliances In acc``orr��anc1e,1w t e provisions of the Plumbing Code of the City
of Cupertino, and all other laws applicable thereto. :
v BLOWER FURNACE
aBETTER CUPERTINO HOMES
Use of Premises
'a
SAN CARLOS SHEET METAL WKS.
h Owner 7"r4 nl n rni Ir.lTv oC .Addrefs CARLOS
13 Address
CONTRACTOR, AGENT
Phone Approved
PLU GING INSPECTOR
Remarks (Check J)
Type of Appliance I Units Fees II New Replace Relocate
Gas Ranges
Wall Heaters
Gas Plates
Circulating Heaters
Blower Furnaces
Gas Fired Boilers
Warming Ovens
Percolators
Griddles
Steam Tables
Gravity Furnaces
Suspended Unit
Floor Furnace
Miscellaneous
NAME TYPE) I -
I II 1 1
pp lance Fees /.S I
Inspected and Approved%a/F�/. .: .. .
DATE .INSPECTOR
HOUSE GAS'PIPING
Number of Outlets Size'of Main_
Gj� ming FFees I .
Tested and Approved ..............:...... .. ...............................................
DATE INSPECTOR
f
GAS SERVIC NOTICE OFFICE.
. ^
COPY'.
BUILDING INSPE OR'S OFFICE
CITY.OP,CUP .RTINO•.
To
You are hereby authorized
to connect the GAS service for
Owner or Tenant . /
Ca/�•'. - � -------—/.STS=../!-!�'�."'.�'.�'............
At /0---�/ ...1.... - - ... .. .. .... . - .//a ..�..........
New Service ................
No. of Meters ..... .............. . Reconnect ....:..................
Move Service.jE-e........:.......
:...
No. of Add. Meters .............. Move Meter ..:.........................
--.... ............ . .. .. .. ... ................
MBING INSPECTOR
110 6/59.500 ..