321 (2) LOT NO.
NO. STREET -
2
APPLICATION FOR GAS PERMIT !
® OF CUPERTINO
Date' 6� ®��aa195J. Permit No. - �a• /� ,• M'
N /� rDT ^^''n Fee
G lyati0f, l �!M City of Cupertino for a permit to install gas pipes
!� and/or gas appliances as listed on the 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. "
BLOWER. FURNACE
BETTER CUPERTINO H0�ME S
Use of Premises
a _ .
°= SAN CARLOS SHEET METAL WKS.
in Owner N!7 a n 1 n r.❑u N7Y RD..Addtess
CARLOS
By Address
CONTRACTOR, AGENT -
Phone Approved
PLUA PING INSPECTOR .a„�
Remarks (Check Irl
Type of Appliance I Units Fees II New Replace Relocate
GaRanges S'
all Heaters � � .• �� ',
Gas Plates
Circulating Heaters
Blower Furnaces
Gas Fired Boilers
Warming'Ovens
Percolators '
Griddles
Steam Tables
Gravity Fdmaces
Suspended Unit
Floor Fuinace
Miscellaneous
NAME TYPE)
pp lance Fees (--�—�-
Inspected and Approved --- .----- -------
DA
'-DA E INSPECTOR
HOUSE GAS PIPING'
Number of Outlets Size' of Main
Gas Piping Fee,
Tested and Approved ............:............ .:...................................
........
DATA INSPECTOA
GAS SERVICE NOTICE OFFICE
COPY
BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTINO
................................................................... 19....
To
You are hereby authorized to connect the GAS service for
"Owner or Tenant
At
New Service
No. of Meters ..:.-/............. Reconnect
..............................
Move'Service ...............
No, of Add. Meter, ............ Move Meter ........ ---------
-- - ------ ...
BO
INSPECTOR
t]0-6/59-500