1559 LOT NO. '33
NO. 3 7
® AP�FCA f0 R PPLIANCE PERMIT
/NOV 8 1963 ' I I OF CUPER LINO
Date NOV 6 1963 196----- Permit No. '16
CITY OF CUPERT:^"' Fees_/o. oQ
Application i3 hereby made to the City of Cupertino for a permit to install
ogas appliances as listed on the reverse side hereof, and agrees to install slid'
appliances in accordance with the provisions of the Plumbing .ode of the City
of Cupertino, and all other laws applicable thereto.
Use of Premises 14-Z-4-4
r7i Ownerfl&'..cuJ _ Address_f'G'
By DIUISIDN Address
HEATING & Slfii@I`T>lt CBePlT'
ieo huP�Umar Approv
PLUMBING INSPECTOR
Remarks (Check ✓)
Type of Appliance Units Fees II New Replace 1 Relocate
Gas Ranges I 1
Wall Healers - I
GasPlates
Circulating Heaters
Blower Furnaces ccs
20o I '�
Gas Fired Boilers
Warming Ovens
Percolators I 0
Griddles
Steam Tables
Gravity Furnaces I_
Suspended Uni
.Floor Furnace
t I r
I II
I I II
Miscellaneous
�NAMF TYPE)
/ues 2 z•oo II
foo I- I
Per�mt i z oo III 1
pp lance Fees o —I�--
Inspected and Approved ...... ...................................
TP. INSPECTOa