120 (2) LOT NO.
" 1C' STREET 'S- '
- P R N
ICATION FOR APPLIANCE PERMIT
25 19SO `C • OF CUPERTINO
IMA
MAR L2 1960
Date 196..... Permit No.��_
_ CUPERTIN w
i' Fee S
T Application is hereby made to the City of Cupertino for a permit to install
;. gas appliances as listed on the reverse sine 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 ✓ ^r ti
8
OS Owner nnV�Rl Address_
$y_*pnnnl� «m Pic CO. Address
180 E. SUNNY RfffTA 4.PCAEsOS", CR C�& )�
Phone PLUIdBING INSPECIbR V/
i
r n
Remarks (Check ✓)
TYPo,of Appliance I Units Fees II New.; I Replace I Relocate
Gas Ranges IT
Wall Heaters I I I I
Gas Prates I I
I Circulating Heaters
Blower Furnaces I / I /• O II I I
as Fired Boilers I I
GI -
Warming vens I I I
CPercolators
c[id8les I I II I I
SfeamtTables I I I
Gravity Furnaces I 11 I
Suspended Unit '
Floor Furnace
I I I
Miscellaneous I I ii
, NAME TYPE) I I I I _—
I I II I
I I III h_
AppFance Fees
Inspected and Approved . . ..7. ?....
D TP / INSPECTOR
ij '
GAS SERVICE NOTICE OFFICE
IliBUILDING INSPECTOR'S OFFICE
CITY OF CUPERTINO
-------------- 7. 191 .
------
To
You are hereby autho 'zed to connect the G ervice for
Owneror Ten.... ...._.......CA.................................................. ............................................
At .........
.... ... ----- . .....................................................
New Service
......................
No. of Meters -----L...._........ Reconnect ..............................
I Move Service ............_.........J
No. of Add. Meters .............. Move Meter ..........................
Ij
...................................t..............................
PLUMBING INSPECTOR
110 6/59-500