2473 1x15 4 orAP TrPP Tang ¢~ LOT NO. 4
O. STRRE
® (CATION FOR GAS PERMIT.
_ CITY OF CUPERTINO
3e ! AUG 9 1963
n
Date ,Agg_list 1963-. Permit No.
CITY OF CUPERTNO Fee $
Application is hereby made to the City of Cupertino for a permit to install gas pipes
and/or gas appliances as listed on the reverse 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
c
..i Use of PremisesbPadgHgg
Owner- Rloasom Valley Homes Address 10554 Orange_Tree lane
By Amaral Plmnbing Address 3390 The Alameda
CONTRACTOR, AGP.NT
(1. Phone A?Pk-3963 Approved
3/ PLUMBING INSPECTOR
Remarks (Check ✓)
Type of Appliance I Units Fees 11--Ke—wI Replace Relocate
Gas Ranges
(Wall Heaters
Gas Plates
Circulating Heaters
-Blower Furnaces f
Gas Fired Boilers
Warming
Percolators
Griddles
Steam Tables
Gravity Furnaces
Suspended Unit II
Floor Furnace
Miscellaneous
NAME TYPE)
7pp I�Fees f
inspected and Approved ---..........:._ ............_..................................
DATE. INSPECTOR
HOUSE GAS PIPING
Number of Outlets Size of in r r
Gas Piping Fees "
Tested and Approved .... ....................
D TR U INSPECTOR
GAS SERVICE NOTICE oPP1Ce
COPY
BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTINO
......................... .�...-......�................... ., 19
To "
You are hereby auth 'zed to connect the .GAservice for
'Owner or Tenant ............_'.. ._ --
, l p.
.
At ................. ....Lo.��I-c(�.. ,.. ..... ....:. . ... .1-------.------
�r.............. evi Servi�......:....
No. of Meters .....eters . .` .
. ' Reconnect .......................:......
. Move Service ........................
No, of Add. Meters .............. ve Meter .........................
��. .
PLUMBING' INS P C OR
110'6/63-500