503 j
LOT NO.
NO. STREET F
2155 APPLICATION FOR GAS PERMIT
baCITY OF CUPERTINO
y !
�M
Date 1 5 Permit No.
f MAY 26 1959 °' Fee $ �D
Application is hereby made to the City of Cupertino for a permit to install gas pipes
and/or ga �IjAngFp[�s l ale side hereof, and agrees to install said pipes
and/or ap a �dtes ! acco c t age
of the Plumbing Code of the City
of Cupertino, and all other laws applicable thereto.
24
v - Use of Premises
3n Owner Address ,/3
By Address`
AG
Phone P' O. Box b7� Approved
UnnyvB e, Cau. PLUMBING INSPECTOR �'
Remarks (Check ✓)
Type of Appliance I Units Fees I 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 j II
Floor Furnace
Miscellaneous
(NAME TYPE) I II
pp lance Fees
Inspected and Approved .........._..:... ................. ... .............. ...:..
DATE. .INSPECTOR
HOUSE GAS-PIPING
Number of Outlets 1 _�2— 1Size of Main
Gas Piping �j
Testedd
and Approved ...../._.._7._.-... - -
DATE - INSPECTOR
GAS SERVICE NO C,E' °opCE
BUILDING INSPECTOR'S:
CITY OF CUPERTINOU"''
---
... .................. ..
--.:..L. a...... .., 19.5
To
You arc herebY authorized to connect the GAS service for
,
Owner or Tenant - ----- / .. ...
At :/a. �.:.: ...... .
........... . .......... ........ :. °.-. . % 3..: �
New Service..... .........:......
' No. of Meters /.. .:....:. Reconnect
...............................
Move.Service..._.....t...._...........
. Move Meter---.._.:•.... :.
No. of Add. Meters........ r{�.............
' -t-.6- V .... ........
PLUMBING'.INSPECTOR
110 6/59-5m .