868 ( oZSt
Lo,No. 25
No. Tract #2880
i P
PPLIANCE PERMIT
tit JUL 1 D 19 CUPERTINO
Date 6/27/62 196..... Permit No.�
CITY OF CUPERTINO Pee $ / ,
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 said
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appliances in accordance with the provisions of the Plumbing rode of the City
of Cupertino, and all other laws applicable thereto.
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Use of Premises R a a
u
ARLL
Thomas
ETCAinWOl21C5� — Address259 r , ,, „ Aire
By _NTY ROAD Address Campbell
Phone CgL'y �Ncc�"7 Approy
.PLUMBING INSPECTOR
Remarks (Check ✓)
Type of Appliance Units Fees II New Replace Relocate
Gas Ranges
\Gaal!Heaters
Gas Plates
Circulating Heaters
BloWer Furnaces
Gas Fired Boilers
Warming Ovens
Percolators 1 �_
Griddles
Steam Tables
Gravity Furnaces
Suspended Unit I I
Floor Furnace
Misrellaneous
(NAME TYPE I ��
PP lance ees
Inspected and Approve �•..--.....
DATE. INSP TOR
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