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2332 (2) 6 C ' M 'LOT NO '1I' NO. - STREE IC j�„ N FOR GAS PERMIT ® OF CUPERTINO N 13 1963 Date 1 Permit No. ' CI OF CU ERTI6VOPee $ Application is hereby made to the 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. y Use of Premises a 05 Own � `�"`� Addre B Addres CON ACTOR, A E Phone_L% Approved / I PLUMBING INSPECTOR Remarks (Check ✓) Type of Appliance I Units .Fees II New Replace Relocate Gas Ranges Wall Heaters -Circulating Heaters Blower Furnaces �� r Gas Fired Boilers Warming Ovens I Ir Percolators Griddles Steam Tables Gravity Furnaces ,I Suspended Unit Floor Furnace " Miscellaneous iiNow NAME TYPE), I ! pp lance Fees �I Inspected and Approved .._..........:...!. DATE. .INSPECTOR HOUSE GAS PIPING Number of Outlets ,� Size of Mai 1T Gas Piping Fees.�� Tested and Approved ...........t.7 .� --j.r-�....................... 4AT¢ INSPECTOR GAS SE*RVICE* NOTICE OcFFopy.ICE BUILDING INSPECTOR-S:OFFICE CITY OF CUPERTINO ' . .................................... ......... ............. A.. To You are hereby anth Arid to connect the GAS ce for Owner or Tenant .............. ... .......................... . ............. . .................. ...... 0 At ........ ........ .............✓..... . ... ................I New Service .......................... No. of Meters ........ ......... Reconnect .............................. .,Move Service ....................... No. of Add. Meters ....... ...... veMeter ... Ito 6/63-5 60 PLkU, N ,,NS.,