515LOT NO.
,;. APPTfpN iQR APPLIANCE PERMIT
i C Iii( OF CUPERTINO
(, S� fit. 2 /L 196`t (;'��
: 'Date - L t , — L496""... Permit No. "
IY of uVgP TlNO Fees
1 50
""`App kation is hereby ma e to the City of Cupertino for a permit to install
ga`s appliances as listed on the reverse side hereof, and agrees to install said
appliances in accordance with the provisions of the Plumbing f7ode of the City
of'Cupertino, and all other laws applicable thereto.
.. Use of
Pe31,—�-P_Ce
1�0 5 Gi7men LjCOtJTRACTOR,LAGRNT�4
•..�e..holl [n:i rsr a APProvec
Type of Appliance!IUriit
Fees II
Remarks (Check d)"
New. Replace I Relocate
Gas Ranges
l„ .,• 11
I I
Nva-11Heaters
I F,
Gas Plates .
I I II
I
Circulating Heaters
1 II
Blower Furnaces
11 II
I I
Gas Fired Boilers
I
Warming.Ovens
Percolators
Griddles
Steam Tables
Gravity Furnaces,
Suspended Unit'
1 I
II I —
Floor Furnace
I I
II I
Miscellaneous
I
I
(NAME TYPE)
I I
II_ I
I i
II I
I
II I ti rl
pp lance eF es
Inspected and Approved .L:�.. .t%L... .._ ...........
DATE INSPECTOR '
r.
e, License c?6A2 `1.385
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emarks (Check J)
Tvpe of Appliance -•[b its. ,Fees II New I Replace I Relocate
Gas plates 4;;'dH
II
I I�
�•� II
I I •
Miscellaneous
NAME TYPE)
I I
Incnerted andfAboroved .......'.: J,
HOUSE
of Outl
0.6C... `-- i ... ... _...........
Approved . _ J.-------_-"
GAS SERVICE NOTICE 1 OPYE
BUILDING INSPECTOR'S OFFICE
CITY „'OF CUPERTINO
�� �.......
To . I96
-You are hereby authorized to -connect the GAS service for, J,
Owner or Tenant
.....
� x•
Atr,,20_ . ?:5.-.,..:, .. L .......................................
., yr
New Service
•:. l,"
No:,ofiMeters ---
r.•.., -... Reconnect
-,y.: ,•-. Move Service
No. of Add. Meters .............. Move Meter -------- .-- ---.._
PLUMBING INSPECTOR
a:
q,,1 10 1/60-500
_e=