1368nT o"6Ok."�z
No. STREET
D �
1 � FOR APPLIANCE PERMIT
`AUG 21 1963 LCITY OF CUPERTINO
dam, �y
Date ��•� , 19G�,F Permit No.
CfTY OF CUPERT Fees 9 So
4 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
O appliances in accordance with the provisions of the Plumbing rode of the City
of Cupertino, and all other laws applicable thereto.
0
Use of Premises
h CronerA�ll��// 7:
s Addresso �•
C NTMCTOR, AGENT
Phone F '530 _T Approve
eiuuEuaG rNsrxcTox
Type of Appliance I Units Fees II
Remarks (Cheri. ✓)
New Replace �I Relocate
'Gas Ranges I�
, II
Wall Heaters
��
'Gas Plates
Circulating, Heaters
MBlower Furnaces
Gas Fired Boilers
Warming Ovens TI
Percolators
Griddles
Steam Tables
_a
Gravity Furnaces
Suspended •Unit——^jj—�
Floor Furnace
Miscellanebus
NAME TYPE I
�I
V-
I�
pp lance Fees h L
1 f
Inspected and Approved
... . _. �.
...........................
5'OA p, INSPECTOR