308 (2) LOT NO.
NO. STREET -
APPLICATION FOR GAS PERMIT
1 ® OF CUPERTINO'
Date , Permit No.
WWW f Fee $
N
Ap reyL�;, h�7�y�qr'ty of Cupertino for a permit to install gas pipes
and/or d p�I" s as"'IWo LE6erse 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
Use of Premises BETTER CUPERTtNO HOMER
u - IDLEWILD TR #215
�n Owner BAN CARLOS SHEETAd�dresjAL WKS.
..779 OLD COUNT`S RD.- SAN CARLOS
By Address
CONTRACTOR, AGENT
Phone Approved G
PLO BING INSPECTOR
Remarks (Check ✓)
Type of Appliance Units Fees IINew Replace Relocate
Gas Ranges
Wall Heaters,
Gas Plates
Circulating Heaters
Blower Furnaces �-
Gas Fired Boilers I ��
Warming Ovens
-Percolators -
Griddles
Steam Tables I 1 II I I
Gravity Furnaces
Suspended Unit Ii '
Floor Furnace �� I
Miscellaneous I I ;I
NAME TYPE) I II
I I II I I
tpppnce Fees ,ed and.Approved ....... ......................
DATE INSPECTOR
HOUSE GAS'PIPIN_G
--
Number of Outlets I ..I ;,;Size of Main �.
Tested and Approved ._.......-...........I...... .....................................
DATE INSPECTOR
GAS SERVICE" �TICE' OFFICE
i BUILDING INSPECTOR'$ OFFICE corY
CITY OF CUPEIETINO
To
You are hereby authorized to connect the GAS service for
.Owner or Tenant o'i -.... . . .............. ..
. .. �.............._---.......-. ............:.-
...--- . Service .v...................
New
No:of Meters .:..._ ............... Reconnect .......................:.....
Move Service ------:......
.........:. '
No. of Add,'Meters .........:.... a Move Meter ....................
LU BG INSPECTOR
IN
110 6/59.500