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APPL'ICATIONt FOR APPLIANCE PERMIT
�JP.t1 J ;„ 3 ICrrr OF CUPEATlNo
_Date li-q/61
- .'. ' 196... Permit No.
Q, C �r-CITl � r1VI)
Fees
Application is hereby made to,the City of Cupertino for a permit tit t Instll
gas appliances as-listed on the reverse side hereof, and agrees to install said
'«' appliances in accordance with the provisions of the Plumbing rode of the Ci
.of Cupertino, and all other laws applicable thereto. ,+ City
ur,,
Use of Premises Bees
m ARLO * Address . C
USAN CARL055HEET METAL —
j Address
'
GENT
SAN,'LARLOS
Phone Z a Approv
' PLUMBING INS
PE
r
Remarks (Check ✓)
Type of Appliance Units Fees II N,ew. ^;;Repla !e IIRelocate i
Gas Ranges
\(all Heaters �� "'70- -,v T'. j
Gas Plates
Circulating Heaters
- Blower Furnaces _
Gas Fired Boilers
Warming Ovens. „
Percolators
Griddles
Stea Tables
ari it,
Sus ended
(NAME TYPE,)
--rsid- err y"
pp lance ees �
Inspected and Approved . ..` . .... ....... .. _.'
DATE. INSPECTOR
I