897 (2) LOT NO.7 7
NO. STREET
APPLICATION FOR GAS PERMIT.
Grp CITY OF CUPERTINO
Date d' 195_ Permit No.
AN 20 1960
f'! Fee S
nAp�lic�tion isr IIiZx�T made the City of Cupertino for a permit to install gas pipes
an Ar gas appliances asrl;sted1onChe reverse side hereof, and agrees to install said pipes
and/or appliances in accordance with the provisions of the Plumbing Code of the City
of Cupertino, and all other laws applicable thereto.
v
:
Use of Premises
a
v
ro
h Owner Aoki Address
By Address
Phone
CONTRApproved
ACTOR, ncE WILLIAM D. BENEVICH
PLUMBING INSPECTOR
Remarks (Check •d)
Type of Appliance I Units Fees I New—1 Replace I Relocate I
Gas Ranges
Wall'Heaters
Gas plates I II
Circulating—HcatersI 1 II
Blower Furnaces I -
Gas Fired Boilers
Warming Ovens �� •�
Percolators .�
Griddles -
Steam Tables
Gravity Furnaces
Suspended Unit II
Floor Furnace �-
Miscellaneous it i
NAME TYPE I I II
pplance Fees �Inspected and and Approved ..... --------:... ........ ......................__.............
DATE. INSPECTOR
HOUSE GAS PIPING
Number of Outlets L I Size of Main
Gas•Piping Fees
Tested and Approved ..
PP , INSPECTOR