864 o?'a l LOT-No. 2]
NO. STREET Tract #2880
TI I� PPLIANCE PERMIT
AL 10 1962 �ERTINo
Daze--6 127 /6P 196----- Permit No.�_
GIGO I OY F CUPERTINO Pee $
N Application is hereby made to the City of Cupertino for a permit to install
O gas appliances as listed on the reverse side hereof, and agrees to install slid
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
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Owner Thnmac Cnrtal-» _ AddresQ59 r_�,jT pV
4.
S CARLOS SHEET METAL WOLAGEPN:f
C. Campbell
-6tB_.COU COUNTY R Address P
S� l CARLC � �
one Approved
PLUMBING INSPECTOR
Remarks (Che& '✓ '
Type of Appliance Units Fees II New Replace ReWate
Gas Ranges i
Wall Heaters � � ��
Gas Plates
Circulating Heaters
Blower Furnaces
Gas FiredBoilers
Warming Ovens l 1
Percolators
Griddles
Steam Tables
Gravity Furnaces
Suspended Unit I l 11
Floor Furnace
Miscellaneous
NAME TYPE) I I III
pp lance ees
Inspected and Approved ... ...... .
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