2336 (2) LOT NO.
No. e
® o ICA ION FOR GAS PERMIT
. OF CUPERTINO
/JUN 13 1963 tom.
Date pp/�Ig . Permit No. 336
0F RTiIV1/ Fee $
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 lawssapplicable thereto.
05 dres d
1 -1 i Addre
O TRACTOR, GEN 1t
Phone 7 I Approved t.p�GL
1 1 PLUMBING INSPECTOR j
Remarks (Check ✓)
Type of Appliance I Units Fees I New Replace Relocate
Gas Ranges _
Wall Heaters
Gas Plates
-Circulating Heaters I I
'Blower Furnaces
Gas Fired Boilers
Warming Ovens
Perco,lators _
Griddles
Stean: Tables
Gravity Furnaces -
Suspended Unit •�
Floor Furnace
.Miscellaneous �j
(NAME TYPE)
pp lance Fees f
Inspected and Approved . .;_.......:... .......................................
DATE .INSPECTOR
HOUSE GAS PIPING
Number of Outlets Size of Main
Tested and Approved
7ATE INSPECTOR
-
GAS SERVICE NOTICEOFFICE
COPY
BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTINO [/
........................................................----...---i., 196.T
To
You*are hereby autho i d to conned the GAS s rvic for
I
Owner or Tenant ---.......... .. ... ..:.. .....�... .. .- - - .._�_.......
At _........\...�S ..a.....:._ - ..... .
New.Service ......G ------
No. of'Meters .........f.`........... Reconnect ...............................
Move Service ........
No. of Add. Meters .............. .MoMeter ..................:.......
A
PLUMBI INSPECT
110 6/6;-500 -