1761 :�'e 4 PFJ LOT NO. ►
NO. �YRyI
„ < R APPLIANCE PERMIT
film AY 20 1964 OF CUPERTINO
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3 a Date `Z,//� 2
196Permit No.
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CITY OF CUPERTINO Fee $ /l ° d
' o Application is hereby made to the City of Cupertino for a permit to
o a install gas appliances as listed on the reverse side hereof, and agrees to
<(ainstall said appliances in accordance with the provisions of the Plumbing
W Code of the. City of Cu�ertino, and all other laws applicable thereto.
Use of Premises (_�`•„a,.i
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W Uwne ,e'Cy/,2 ¢ oS;n,) Address
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2.o RF � m T�ddress�� �d R��udo Y�IK/Jr
CONTRALTO AGENT
— 0 Phone
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a o State License �� /� Approved
U PLUMBING INSPECTOR
Remarks (Check J;
Type of Appliance Units Fees IF New I Replace I Relocate
Gas Ranges
Wall Heaters ; I
Gas Plates I _
Circulating Heaters �—
EE
Blower Furnaces II
Gas Fired Boilers I I I
\Y/arming evens I I I I
percolators
Griddles II
.team Tables
Gravity Furnaces I I�
Suspended Uniti
Floor Furnace
Miscellaneous I I I
(NAME TYPC•� I II I ,_
pp Iance ees / Dq I
Inspected and Approvedo .— ....:........ ..................
DATP. INSPECTOR