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1764 o. NO. s „ a OR APPLIANCE PERMIT W D MAY 201964 OF CUPERTINO £ 0 Y (n RLL J Y 3 'a Date— 196 Permit No. U Fee $ W W CITY 0 , C PERTNO /- ' 0 App kation 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 iN install said appliances in accordance with the provisions of the Plumbing W = Code of the Cite of Cupertino, and all other laws applicable thereto. aUse of Premises 00 5 3 Owner Addre _ Z — 4 year PZ�.�,�� Z Address 3'O CONTMCTO ,AGENT a Phone W � Z WW 0 s State License Approved a0 _U PLUMBING INSPECT v Remarks (Check J; Type of Appliance Units Fees II New Replace 1 Relocate Gas Ranges 1 11 — Wall Heaters Gas laces 1{I Circulating Hinters I II Blower Furnaces Gas Fired boilers 1 { II I Watrning Ovens Percolators 1 1 SQ —�— res teeamam Tables { 1 II I I Gravity Furnaces Su spended Unitil Floor Furnace { I1 Miscellaneous NAME TYPE 1 I ��� I �l?•�o II I _��i r I 1�•tw II I _ .PP Lance ees ,pv Inspected and Approved✓r_�� . .... .. . ............................... DATE. INSPECTOR ILL AGREE \ VIOLATE. �& N > � o 0 ® � & d �/ . \f ( \ q - . _ K Xx � _ ` / / m CA _ 01. 10 } \ \ to . _ } � t * (% �} / ) 2 . . / B 2 ; ; r 'I o ` | 4a¥ s ® m . / \ 0 � / �o \Zll 1-31 I i V } � � ' § � ) / � � � � � P4 ƒ ' } } } () / ) \ \ \ \ / / j �/k \ � ; z an . / / \ \ ) i / \ C3 \ \ \ ) / \ \ \ / / \ � & ! ) ) } § 2 2 114 a o H '0 K ^n w ie `e w p a: n tz O N rn T � � m ro � 00 --1 C1 ry = Q C) m 2 no H : f x p p z z > 0 p 0 0, ( \ \ } � \ { e § q kB X52 ® \ . 4 \ . » o o z 0�