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OR APPLIANCE PERMIT
z Z OF CUPERTINO
I LL MAY 20 19 4/
a Date / 196_i_
96 Permit No. / V'
CITY q giVfXKTJ4Q Fee $ a p
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° A Lica I t made to the City of Cupertino for a permit to
o F install gas appliances as listed on the reverse side hereof, and agrees to
i N install said appliances in accordance with the provisions of the Plumbing
v = Code of the City of Cupertino, and all other laws applicable thereto.
LLUse of Premises
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° c CONTRALTO ,AGENT
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a o State License Approved
U PLUMBING INSPECTCId
Remarks (Check tri
Type of Appliance Units Fees II New Replace I Relocate
Gas Ranges �—
�all Heaters I ��
Gas Plates
Circulating Heaters I j
Blower Furnaces
Gas Fired Boilers
Warming Ovens j I II
Percolators I j
Griddles
Steam Tables
Gravity Furnaces
SuspendedUnit J
Floor Furnace
I I II
Miscellaneous
(NAME TYPE I I
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pp lance ees p
Inspected and Approved 67- .:_J:...... .. ...........................
DATE. INSPECTOR
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