325 vor No.
NO. STREET
rJ 5 APPLICATION FOR GAS PERMIT
OF CUPERTINO
Date r 9 Permit No.
t113 { AM 101959 N ' Fee $
Ap y nre ty of Cupertino for a permit to install gas pipes
0 and/ort plibles a2fterse side hereof, and agrees to install said pipes
and/or appliances in accordance with the provisions of the Plumbing Code of the City
of Cupertino, and all other laws applicable thereto.
u BLOWER FURNACE
Use of Premises BETTER
CUP
Use HOS
IDLEWILD TR. ir£I5_
SAN CARLOS SHEET METAL WKS.
in Owner * -,D Address CA RLC'
By Address c
CONTRACTOR, ncENr
Phone Approve
PLU (SING INSPECTOR
r
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 II
Floor Furnace I
Miscellaneous
NAME TYPE)
pp Iance-Fees 3�
Inspected and A'PProved '.(x/71 .
DATE. INSPECTOR
HOUSE GAS PIPING
Number of Outlets Size of Main
Gas Piping Fees
—3— —
Tested and Approved ....._.......:...:..._ ........................................
DATE INSPECTOR