494 ►D3 ( / .� �. LOT NO.
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"bIC/l�.TIS� lI FOR APPLIANCE PERMIT
11��6611 $�nCITY OF CUPERTINO
1COTtAWATIAIM ., 196----- Permit No. 4 q T/r
Fee S
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 said
appliances in accordance with the provisions of the Plumbing bode of the City
of Cupertino, and all other laws
applicable thereto.
UseofPremises
Owner (rw+ d l o RING HEATING COMPANY
Address _
By R Address NN L . CALIF09Nie
A,,fCONTRACTOR, AGENT
Phone Approv
PLUMBING INS HfTOR
Remarks (Check ✓)
Type of.Appliance I Units Fees II New I.Replace Relocate
Gas Ranges
Wall HFaters
Gas Plates
Circulating Heaters
Blower Furnaces
Gas Fired Boilers
Warming Ovens
Percolators T
Griddles
eam Tables
Gra+ity Furnaces 1 1
Suspended Unit
Flour Furnace
Miscellaneous
(NAME TYPE) I ��
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Inspected and Approved
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DAT INSPECTOR
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