1178 O SO� Rolfe Road Lar NO # 13
No. smear
IR R APPLIANCE PERMIT
�,1MAR 2 81963 OF CUPERiINO
Date- ffaroh 20th 196._S. Permit No.
CITY OF CUPERTINO Fee:10.75
a Application is hereby made to the City of Cupertino for a permit to install
Lo
Lo gas appliances as listed on the reverse side hereof, and agrees to install said
,wr appliances in accordance with the provisions of the Plumbing rode of the City
N of Cupertino, and all other laws applicable thereto.
a UseofPremiaes Triplex - new-dwell6ng
Owner Lee - Tom Interpriaea_ Address loin . Ave A_J.
gy ROYAL SHEETMBT•_%'; A 88 C Ave. - Campbe
Cotvraecroa, AGWIM
phi 878-7481 Approved
PLGNa1NG VNBP
T T
Remarks a1e0 1r
Type of Appliance_ Units Fees New Replace I Re Date
Gas Ranges
NVsll Haters 4 �� S
Gas Plates II.
Cir sting Haters
Blower Furnaces
Gas Fired Boilers I
arming Ovens I
Percolators _
Griddle II
Steam able
Gravity Furnaces (— i
'Sus de�Unit
Floor Furnace
Misce�oes
NAME TYPE)
BEAT Duos 0.25 2.25
Us Outlets b LOW I
Permit 2 —
I
pp lance ^ea b 1 I7'
Inspected and Appro'ved),I. .. . At .............................
p g INSPECTOa