462 (2) LOT No.
.s.. No. - STREET
APPLICATION FOR GAS PERMIT_
CITY OF CUPERTINO
c
Date FIE
��.: ,� - Permit No:
I MAY 7 1959 Fee $ J
Ap atron is hereby made to the City of Cupertino for a permit to install gas pipes
1, and/or gas appliances as liste�(��1 verse side hereof, and agrees to install said pipes
and/or(aB�lynco F aG�URUftmae provisions of the Plumbing Code of the City
of Cupe no, and all other laws applicable thereto.
� o
V
Use of Premises-
45
remises 45 Ownes%1�i /- / i+l r ra./SyfQAddress
By Address
W. L. Hlfiu3faeci3gLweNNC.
Phone P. O. Box 576 _ r Approve Z=
u�t.�
Sunnyvale. Calif. 11 PLUMBING INSPECTOR s,�
Remarks (Check ✓)
Type of Appliance (Units Fees lhNe—wj Replace I Relocate
Gas Ranges
Wall Heaters
Gas Plates
Circulating Heaters
Blower Furnaces
Gas Fired Boilers
Warming Ovens
Percolators
Griddles.
Steam Tables
Gravity Furnaces
Suspended Unit �-
Floor Furnace
Li
Miscellaneous
NAME TYPE) I I .�•
pp lance Fees
Inspected and Approved ..............:...
DATE INSPECTOR
HOUSE GAS'PIPING
Number of Outlets Size of Main
Gat Piping Fees I / I/ ,
Tested and Approved ....-0. !``J ... _ .. . ... ................._............
DATA INSPECTOR