380 (2) iC7l I \ / `�/! �/1/1• LOT NO. .
NO. STREET ,_r, ,
APPLIANCE PERMIT
+ / ES �9U1 t OF CUPERTINO
: 7Ut
Date /' 196--- Permit No. 0
CITY OF CUPERTINO Fee s-t�-
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 slid
appliances in accordance with the provisions of the Plumbing rode of the City
of Cupertino, and all other laws applicable thereto.
Use of Premises ,
Owner ^ �C 1�/���1 _ Address 3l &'X-tp
iY
By� ffl�1�+d�O Address
CON1AACTOR, AGENT Q n�
Phone Approved c 1'+�
BING P
Remarks (Che Jl
Type of Appliance Units Fees II New Replace Relocate
Gas Ranges
_\�Uall"H�aters
Gas Plates ��� �
Circulating Heaters
Blower Furnaces
Gas Fired Boilers
Warming Ovens
Percolators � � ��
Griddles
Steam Tables
Gravity furnace
Suspended Unit
Floor Furnace
Miscellaneous
�NAMH TYPO
pp Iance I:ees
Inspected and Approved lo%. ...... .............•...........•......•...
ATP INSPECTOR