1283 COT NO.ZZ �
NO. STREET Tract2 0
® Pi&I TIC'N�R APPLIANCE PER
OF CUPERTINO
191963 LV
Date 6/17/63196..... Permit No.co W/ 3
CITY OF CUPERTiNO Pee S
Application is hereby made to the City of Cupertino for a permit to install
CD
C) gas appliances as.listed on the reverse side hereof, and agrees to install said
H appliances in accordance with the provisions of the Plumbing Code of the City
of Cupertino, and all other laws applicable thereto.
4U
Use of Premises Reg .
u
Cupertino Prop. Ltd 583 Market St. - S.F.
SA IY CAS — Address
] A OLD COUNTY ROAD r.. Address
SAN CeARLOS. 1-2605
Wqr2KAGENT i k Approvedyy LLfAM D. BENEVICH
t ! ;v�, 7"q i I I r 1 i r PLUMBING INSPECTOR
r_>_ _
Remarks (Check ✓)
Type of Appliance I Units Fees II New, I Replace I Relocate
Gas Ranges
Will Heaters
Gas Plates I I II I
Circulating Heaters
Blower Furnaces
Gas Fired Boilers
Warming Ovens
Percolators I I II I
Griddles
Steam Tables I II
Gravity Furnaces I I_
Suspended Unit I II
FICar Furnace .
Miscellaneous I it
NAME TYPE)
FAA I I P_q I
I I
l 1. Orrt - Tnl lata i 9_'i� i ._
Appliance Fees I 6 X15 I
Inspected and Approved ....... ....:... ...............................................
DATE. INSPECTOR