1177 /0 :57/ e .Raed
Lor No- 17
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NPLICATION APPLIANCE PERMIT
�g�gIMAR 2�8��1996r3criy=of CUPERTINO
Daft M" OF vUPL 1;x'196-1 Permit No
Fee S 10.75"
ti Application is hereby made to the City of Cupertino for a permit to install
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gas appliances as listed on the reverse side hereof, and agrees to install siid
appliances in accordance with the provisions of the Plumbing rode of the City
ce of Cupertino, and a8 other laws applicable thereto.
8 UseofPremises Triplex - Now dwelling
8
Owner LES - TOM Interprisea _ Addrew1817 Hamilton ave. S J.
By ROYAL SHEET METAL INC-AIQ Add 861 Cam m f1we, Camp.
corrraacroa, aGaPrr
pj 878-7481 APPS
PLUMBniG U45PBi
Remarks
Type of Appliance Units Fees N New Replay Relaate
Gas Ranges �
_\�Uull Heaters �
Gas Plates II
Circulating Heater II
Blower Furnaces .00 I
Gas Fired Boiler
Warming Ovens �I
Permlator
Griddles II
Steam Tables I
GravityFuroaces �--
�SuspEn a Unit
F oor Furnace �.
Misce laneous I
(NAME TYPE)
Hea4 duota 2 .�6I�1
Gar outl to 00
arm ti ..QIL-
I-- —
PP iance Fees
Inspected and A roved . .......................
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