502 LOT N //,Z!/
NO. STREET /' /SS _,
2 155APPLICATION FOR GAS PERMIT
S� -CITY OF CUPERTINO
Date Y ,5195'_ Permit No. —rQ �
MAY 261559 Fee $ /, 3a
Application is hereby made to the City of Cupertino for a permit to install gas pipes ,
and/or�� tli�l�es a�1 BD I Kerse side hereof, and agrees to install said pipes'
and/or app,lancess in acc, ante I e provisions of the Plumbing Code of the City 1
of Cupertino, and all other laws applicable thereto.
u
y
v py G
a
Use of Premises_
in Owner Z� Address
W. L. HICKEY SONS, 1 C, Address
ByV' CONTRACTOR, AGENT ��j� - .9
PhoneSunnyvale, CaIN; Approved (ice etc -
PLUMBING INSPECTOR iyLJ
Remarks (Check d)
Type of Appliance Units Fees II New Replace Relocate
Gas Ranges
Wall Heaters
Gas Plates
Circulating Heaters
Blower Furnaces
Gas Fired Boilers 1
Warming Ovens
Percolators
Griddles
Steam Tables
Gravity Furnaces
Suspended Unit
Floor Furnace
Miscellaneous
NAME TYPE)
pp lance Fees II f
Inspected and Approved ._...........:._!�_...........
DATE. INSPECTOR
HOUSE GAS PIPING
Number of Outlets � � Size of Main
GaS Piping Fees „5D
Tested and Approved ...(.o..7f:.....� . .... . ....
DATE INSPECTOR
" GAS SERVICE NOTICE �oecE
COPY
BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTINO
Q
To
You are hereby authorized-to connect the GAS service for
Owner or Tenan
...... �? ... ........�%LC ....,
......................... . .
At ...�a.� V/...:.. -
New. Service ........`.... ,
No. of Meters ......�...---`---- Reconnect ---:..........................
Move Service......................
- No..of.Add. Meters ...... ....... - Move Meter ......:...:..............
9BING
------ -- .....: _......MINSPECTOR
110 6/59-00 -