682 033L7 .�K LOT NO. #3 _
NO. STEEET A Idlewild #288C
:'APPLIANCE PERMIT
R.
C U CUPERTINO
, ,'FEB 7 3962 !7 `
Date '/5/62 , 196..... Permit No.
CITY OF CUPERTINO Fee $
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 accordance with the provisions of the Plumbing rode of the City
of Cupertino, and all other laws applicable thereto.
�C
v
Use of Premises Res .
�1�Q'oner Rgyyggg&u g�.s. Address
SMSF-E SHEET METAL WORKS, INC. Address I' CISCO•
�7eaf 77 OLD COUN.TddaiaL%5R, AGENT
SAM;( RLOS, CALIFORNI TApprove
�� PLUMBING 114SPS
Remarks (Check ✓)
Type of Appliance I Units Fees II New Replace Relocate
Gas Ranges 11
\Y; Heaters
Ga1s Plates I �
Circulating Heaters
Ellower Furnaces
Gas Fired Boilers
Warming Ovens �� 4
Percolators lI I
Griddles
Steam Tables
Gravity Furnaces
� uependcdit
Fed Unit Unit
Floor Furnace
Miscellaneous � —.--
(NAME TYPE) I ��
—tel l Illi II _
pp Iance ees _
Enspected and Approved INS
D.aZ .... . . .... ...... ................
DATP. SPECTO.0.
0
FL p
t7l
ql
cj�