1749 (2) .. . . 156 t. #3150
LOT NO.
No. sta887 $aSW00 _err
r
PP R APPLIANCE PERMIT
OF CUPERTINO
M� I-
Date �' ��Flall4 796..... Permit No.��
Fee S
c\j �F CeFE�TMO
00 p0li ati is here y ma a to the City of Cupertino.for a permit to install
00 gas appliances as listed on the reverse side hereof, and agrees to install said
H appliances in accordance with the provisions of the Plumbing rode of the City
of Cupertino, and all other laws applicable thereto.
x
E Res .
Use of Premises
ar rump
Dev. Inc. P 0 Box 634.
W) Owner Address
SaB¢arlos Sheet Metal Wor S — Gupert erre —
779 Old Coun y QHS To T Address
SaRRQ&Os, California-26''6 ' 1 I Approved `
t./7I
PLUMBING INSPECTOR 30
Remarks (Check J) .
Type of Appliance I Units Fees II New I Replace I Relocate
I Gas Ranges
.\/all Heaters
Gas Plates I I
Circulating Heaters
Blower Furnaces I I a I
Gas Fired Boilers
Warming Ovens II I I
Percolators
Griddles I II
Steam Tables
'Gravity Furnaces I II I I
us`' peS"nde U it I r
F�ior Furnace.
I
Miscellaneous
(NAME TYPE)
a s I
i 11 e o 1 I
° I --
I i II I
Appliance Fees I "�• r I
Inspected and Approved ..............:... ..........................................
.....
DATE INSPECTOR