Loading...
1416 (2) aoG 7s yup- LOT NO ✓ G NO. .� �sTRBRT•` APPLICATION+ FOR APPLIANCE PERMIT AUG 277, 1963 � 'CII1r OF CUPERTINO e• . ran i��+:�n 196-3- Permit No. Fees 7- Application 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 rode of the City of Cupertino, and all other lawsapplicablethereto. l c A Use of Premises � p� ,A Owner�� _ Address By7 Address — Y O ACTOR, AGENT l A Phone r7 9- y 2- Z3 Approv LL ? . •'✓ I PLUMBING MSPRCrOR Remarks (Check ✓) I Type of Appliance Units Fees II New Replace Relocate Gas Ranges Wall Heaters Gas Plates Circulating Heaters Blower Furnaces Gas Fired Boilers Warming Ovens � � �� Percolators Criddles Steam Tables 'Gravity Furnaces Suspended Unit Floor Furnace Miscellaneous / (NAME TYPE) I&13,0611 & � pp lance l:<:es Inspected and Approved ... .... ...... ..',. . ....... ATE INSPECTOR