983 e�22
e /0 2 &2- LOT NO.
NO. Mas
sTRp
0�' lTnI 5j7 R APPLIANCE PERMIT
Ql'i� 1 }perl•rl OF CUPER !NO:
III ,�x/rG '# C
Da/te OCT 9 1962 196----- Permit No.
-- �� •
W F �� - INO Fee a m0
Application is hereby made to the City of Cupertino for a permit to install
gas appliances as listed on.the reverse side hereof, and agrees to install slid
appliances in accordapci�with the provisions of the Plumbing rode of the City
of Cupertino, and 'alirO er laws applicable ther o.
u
-r>..
Use of Premises
�n
Own er •�`A_ Y Address
DIV19 ON Add" -
rGW
180 f« aNNYBAKS AVE., CAMPBELL. CALIF. Approv
PLUMBING INBP
(Check %7)
'
r Appli.me Units Fees 1::, II New-- Replace Relocate
Gas
Wat eaters
Gas Plates
Circulating Heaters t-.
Blower Furnaces
Gas Fired Boilers %.-1
Fercolators
Griddles
Steam AM
Gravity TmrR4ees
Suspended'
Floor Furnace
Miscellaneous
(NAME. TYPr.)
nj�
PP lance FEVCE�j 6. o
p ,a
Inspected and Approved �V-I/.949n.. .....
14SPIXTAR �
A