28112;cel/ I OT x0. .r. .�...
NO. TR
O
,A N FOR GAS PERMIT
OF CUPERTINO
FMIAY 7 1964
Date 196_ Permit No. t O
f . QF C,1PE�TiNQ Fee $� O
W atio Is here y ma e to the City of Cupertino for a permit to install gas pipes
and/or gas appliances as listed on the reverse side hereof, and agrees to install said pipes
and/or appliances in accordance with -theproviso ns of the Plumbing Code of the City
of Cupertino, and all other la applicable the— o.
Use of Premises
_�- f
Approve
PLUMBING INSPECTOR
1 I 4
of Appliance I Units Fees
NAME TYPE:
HOUSE GAS PIPING
Number of Outlets Size of Main
Gms Piping Fees,
Tested and Approved .. IT............................
DATE INSPECT."
Multi -House Gas Inspection Card
Gas Permit No . ...................................
APT.
NO.
GAS PIPING
TESTED AND
APPROVED
APPLIANCE
INSPECTED AND
APPROVED
FURNACE
INSPECTED AND
APPROVED
.
3.
i
'G.
7.
;8.
9.
10.
11.
12.
14.
15.
16.
17.
1 S.
19.
a0:
2:
2.
24.
25.
116 1/63.500