1748 (2) 'ZZ � //�� � Tract
� a LOT NO. 155. #3X50
No. STREET _ Baywood XTerr
P Td R APPLIANCE PERMIT
CUPERTINO
n
Date—F1 ---.0W� 196..... Permit No.—/— K
GO
Fee S
N 91TY OF CUPERTMO
Go pplication is hereby made to the City of Cupertino for a permit to install
O gas appliances is listed on the reverse side hereof, and agrees to install said
appliances in accordance with the provisions of the Plumbing lode of the City
of Cupertino, and all other laws applicable thereto.
u '
C
Use of Premises R e s
Ward Crump
J5 Owner Dev. Inc . _ AddressP 0 Box 634
San arlosSheet.MetalWors Cupertino
7— h oun y ONTRACTOR, AGE r Address_
San pRdhg, California591-260? i Approved
PLUMBING INSPECT
Remarks (Check J) -
Type of Appliance Units Fees II New I Replace Relocate
Gas Ranges I I I I
Wall Heaters I I
Gas Plates I I II I
Circulating Heated
Blower Furnaces I I
`Gas Fired Boilers I I
Warming Ovens I II I I
Percolators ( II
°Griddles
Steam Tables II
Gravity Furnaces
Suspended Unit I —�
Floor Furnace II
I I I
Miscellaneous
I o
NAME TYPE) I I it
2 Vents
J.1 outlets I I • I
Fee
I II I
Appliance I (�—
Inspected and Approved .. . _ ... ...........................................
AT INSPECTOR