1502 LOT NO
NO.
PPL�IC ' OR APPLIANCE PERMIT
LS,1 SEP 2 7 1963 OF cuP>nT>r'O
196. Permit No V
CITY OF C PERTiN «F : r c�
o 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 '-,ode of the City
of Cupertino, and all other laws applicable thereto.
A�'t0
Use of Premises �t c n Oa,i
u
AddreseAO//c? i 5Tn' ,07
Ad - '4�'�-1 , f!i
coNrnncroa, nseNr
Phone - Appmv
PLUMBING INSPHCTO
Remarks (Check ✓)
Type of Appliance Units Fees I New ( Replace Relocate
Gas Ranges
Tall Heaters
Gas Plates
Circulating Heaters
Blower Furnaces 1414yoll
Gat Fired Boilers
Warming Ovens
Percola7to—r—sI 1 11__.
Griddles
Steam Tables
t Gravity Furnaces �� �
Stsspended Unit-1 _
Floor Furnace
Miscellaneous
NAME TYPO II
q�QPh IL � .00
of cGa I ,dd
G
pp lance ees
—�--
Inspected and Approved I. . .... _ ........ ......................................
DATE n+srecroa