342 n y/ •I
LOT No. /3 0 `
N , STREET ••.
21 55 APPLICATION FOR•GAS PERMIT
CITY OF CUPERTINO
Dat 195 . 'Permit No.__- e - - -
M APR 101959 Fee a' /
Application is hereby made to the City of Cupertino for a permit to install gas pipes
an a� s iar(c�sl� 11 le reverse side hereof, and.agrees to install said pipes
an �10 pp a ces n c r a th the provisions of the Plumbing Code of the City
of Cupertino, and all other laws applicable thereto.
- BLOWER FURNACE
Use of Premises gETTER CUPERTINO, HOMES
`I IDLEWILD TR 1f 215
v.
:"•
SAN CARLOS SHEET h7 TAL WKS.
-Owner A�dress =
779 OLD 0 U NTY hu.- SH IN I.I+
By AlIft Address
CONTRACTOR, AGENT
Phone Approved
PLgJ BING INSPECTOR
i
Remarks (Check ✓)
Type of Appliance I Units Fees II New Replace I Relocate
Gas Ranges I
I
\v4all Heaters
Gas Plates
Circulating Heaters
Blower Furnaces I /
Gas Fired Boilers
Percolators
Griddles
Steam Tables
Gravity Furnaces
Suspended,Unit
Floor Furnace
-
r Miscellaneous
NAME TYPE)
II II III _
� I IIS I II
Appliance Fees
Inspected and Approved .lOr1,9-r j .... .------=- . ---
DATE. INSPECTOR
HOUSE GAS'PIPING
Number of Outlets I I Size of Main I
Gas Piping Fees
Tested-and Approved .... ..........:......I.................................._.........
DATE INSPECTOR
GAS SERVICE t 6 ICE OFFICE
COP}'
BUILDING INSPECT SbFFICE.1
CITY OF CUPE - INO'
............ ............. I
To
You are herebyauthorized to connect the GAS service for
Owner
or
Tenant .><F?/„�E�^"6� ......
At /.f/. J, ----C.X.::Si L GrLr!Grt.�,.t.. .......
New Service J' ............
. No. of Meters -..._./........-.... Reconnect .....'.........:..L.........
r
• - . Move Service1410
.....r.. ..............
No. of Add. Meters ------------- Move'Meter............................ ,
PLUMBING`INSPECTOR”
110 6/59-500
r -