273 (2) #139
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�A lR APLIANCE PERMIT
T1!0FCPPERTlN0
,SEP 30
1960
Date 196..... Permit No.
CITY OF CUPERTINO Fee :
Application is hereby made to the City of Cupertino for a permit to install
gas appliances as listed on the reverse side hereof, and agrees to install said
appliances in accordance with the provisions of the Plumbing bode of the City
of Cupertino, and all other laws applicable thereto.
Use of Premises Res ,
Owner .'+RoLr. qppti_Org. ' }_ Address i- q+- —S'_F,
1
� SAN L'8,�°iG g4��'�;:�A�-•�•9P�o'::7 Address
cei+r•.
779 OLD?E(S�FJ�Y' �PAG o
Approved
.Pwrct IMP
%" �}� Remarks"7(Chedt ✓el' .
Type of Appliance I Untts•»Fees II' New m;J'Replace Relocate
GasR,anges
\t({ali ;eaters
Gas Plates
,.. Circulating Heaters
..Blower Furnaces lix - �, '. '�•
Gas Fired Boilers !�
't:Warming Ovens I 1 11
Pgrcolators. -
Griddles
Steam Tables
Gravity Furnaces
Suspended Unit II
Floor'Furnace
Miscellaneous
(NAME TYPE)
T
—Cpp Iance Fees r
Inspected and Approved .�..��.,.�.//lp1�r���...... ... .......................'..:...
pAT¢ INSPECTOR