1182 O b Rolfe Road Lar NO 14
NO. a7aaHT
EAPROR APPLIANCE PERMIT
OF CUPERTINO
9 1963nate_ March 20 , 196.1. Permit No.�z
CITY OF CUPERTI.^!" Fee$ ra
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
appliamces in accordance with the provisions of the Plumbing rode of the City
of Cupertino, and 'all other laws applicable thereto.
Use OfPcemises Triplex now dwelitigg
�i Owner r.Rs — TOM Interprisea Addnml8,t7 HwAfton Ave. S. J.
gy ROYAL SHEET METAL IRC Ad 8 Ce Ave. Cap.
N 578—Rff 'aoaNr PP
PLUMamaa INSPROBW
Remar Ch - 0 .
Type of Appliance Units Fees II New Replace Relocate
Gas�Ranges ��
V(Wall Heaten .I� �
Gas Plates
Cirntlating Heaters
Blower Furnaces
Gas Fired Boilers
Warming Ovens
Percolators
Griddles
Steam Tables
Gravity Furnaces
rSuspen ed Unit
Floor Furnace
Miscellaneous � � �
, (NAME TYPE)
i
PP lance ees
Inspected and Approve .1. .. ' ...............................
DAT ENSPECTOR