1144 (2) C5 LOT NO. #6 .
NO. STREET W0-Wd"re-rra c!
Tract #3150
AP: Al ,OR APPLIANCE PERMIT
POF CUPERTINO
Date 1853 196..... Permit No. 1 ��
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C1 Fee Fees 7.
N %TIicatl is here y made to the City of Cupertino for a permit to install
c0 gas appliances ai listed on the reverse side hereof, and agrees to install said
• � appliances in accordance with the provisions of the Plumbing--7ode of the Cit
H of Cupertino, and all other laws applicable thereto. y
' c
u
Use of Premises Res.
v Ownelcamino Del H as AddressA
CARLOS SHEET META�''A`�itcs�ty� — 4--
BY779 OLILCOlINry ROAD i —
G AddressSAN� Lp'COPhone 1' ApproveG INSPE 0.
Remarks (Check ✓)
Type of Appliance I Units Fees II New Replace Relocate
Gas Ranges
Wftll Heaters
Gu Plates
Circulating Heaters
Blower Furnaces
Gas Fired Boilers
Warming Ovens
Percolators
Griddles
Steam Tables
Gravity Furnaces I_
Suspended Unit II
Floor Furnace
I I II I
Miscellaneous ,I
NAME TYPE)
EeP �2.00Il I
_ 1 I1 I
u
1 Gas Ot _KOC _
1 it Cot12_.2511—�
pp lan1
ce Fees t 7K
Inspected and Approved ..............:... ......................................
DATF. INSPECTOR