2472 (2) mange Tree—Trane LOT NO.
NO. STREET .
tl
� CATION, FOR GAS PERMIT•
CITY OF CUPERTINOAUG963
Date August 6 - ' 1963 Permit No. IV
TY OF CUPErR NN') Fees
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.
NC ,
V
Use of Premises Residence
Owner B1083CM Valley Homes Address 1420 Orange Tree Iane
By Amaral Plmebing I Address 3M The Alameda
CONTRACTOR, AGENTI
0. Phone—-1�L�3t(J[ ��[/ i i Approved
mac/ /N/� I 4-0 r PLUMBING INSPECTOR
Remarks (Check ✓)
Type of Appliance I Units Fees IINew Replace Relocate
Gas Ranges
Wall Heaters
Gas Plates
Circulating Heaters
Blower Furnaces
Gas Fired Boilers
Warming Ovens
Percolators
Griddles
Steam Tables
Gravity Furnaces
—Ended Unit II
Floor Furnace
Miscellaneous l l �
NAME TYPE) I II
pp lance Fees I I
Inspected and Approved ....... -...:_. ..........................................
DATE .INSPECTOR
HOUSE GAS PIPING
Number of Outlets Size of am
Gas Piping Fees
Tested and Approv . . .. ... .... ..... .....
NS
D TE ) IPECTOR
x
GAS SERVICE NOTICE OFFICE
COPY
BUILDING INSPECTOR'S OFFICE
CITY 'OF CUPERTINO
/ ......... ......... ..... ..V--a 0......... . I96-�k
To
You are.hereby auth 'zed o conned the GA service for
Owner or Tenant ............. ...�� �—a'w--
At ...........1...�..� ....... .. .._(�;,J�.2�. ....... ..... Q.. -...................
(, New Service
..........................
No.'of Meters .......,............. Reconnect ..............................
Move Service ........................
No. of Add. Meters .............. . . . . ove
eter .........................
.... .. ....... . . .. .. .....I :PLUMBNINSPE
110 6/63-500