267 (2) LOT No. #133
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/►PP71i:A'?Ott R APPLIANCE- PERMIT3 T,Q 1 J _ _ OF CUPERTINO ///���
Date 9/23/60 196..... Permit No.
't>0 OF CUPERTINO
Fee.f -�
Application is hereby made to the City of Cupertino fo8a 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 rode of the City
T of Cupertino, and all other laws applicable thereto.,
use of Premises Res _
0
t .
Owner n n T _ Address _ F
SAN LOS SHEET Address_
p 779 OLD C0Q?R114cMAtPE" Approv d
N'�PGABe _ cg A PI,ueIe'I G INSPa a
Remarks (Check ✓)
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Type oft?j6Oliar. I Units` Fees II New Replace I Relocate
Gas Range
IX;311�Heaters ��' I � I
Gis'plates_ ? I I II I
Circulatl�ig�Heaters I I I I
N I 11 IIx I I
Blower Furnaces
GasFired-Boilers'
Warming,Ovens I II
PtKOldtO[S .I _ I�_ I•' I
Ghd'dle3� I I I
SteamiTables' I I I
,FG;Pity Furnaces I' I • I I I
Sdspended Unit ��•':'.rl'' , •'I ii I j
Floor Furnace
Miscellaneous I .
(NAME TYPE) I
I I II I
I I II I
rl ' I 11 I I
pp Ia
,cc Fees
Inspected and Approve ._. .. .........................i.
DATE. INSPECTOR