570 (2) LOT NO.
NO. AIR�
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A -WT• FO ;APPLIANCE PERMIT
OCT 18 19eiTY�CUPERTINO
Date 196Permit No. s 7 f!
CITY Cr CUPERTINOi=�;= _L
". kc `'j Fee JZ
.,'Application is hereby made to the 6ty'of Cppertino for a permit to install
gas appliances as listed on the reverse side hefeoCaiid agrees to install said
appliances in accordance with the provisigns"of.the Plumbing rode of the City
of Cupertino, an other laws applicable,tiOr
Use tif,Premises---°'-
0L ss
re:5
O� : cATINYOAKS�,AVE'Ckgl , or
18o pl; r, .Approved "PLUMBING
BCr a
Remarks (Check ✓)
Type of ApplianceI Units„RFees II New_ I Replace I Relocate
Gas Ranges
Rall Heaters I II I I
Gas Plates I II I
Circulafing Heaters .I t I .'I{Nf”;#<':
Blower Furnaces I /-'� 1 ✓ . I;.rr �,v,
Gas Fired Boilers I •"I I {b"''' "�
Warming Ovens I I I
Percolators I I t "'I
Griddles
Steam Tables
Gravity Furnaces I I I I
Suspended Unit
Floor 'Furnace;`�� I
Miscellaneous
NAME TYAE) .I I II r�•_�... re.t.ii'v'i
:I . . .
pp Bance Fees I I � II h _
Inspected and Approved >I . . .a��...'........ . .........NSPECTOR.............._>.:;.-
ATF / I
z
}� GAS SERVICE .N6TIC'ti�,' , . yoorYE,
:. BUILDING INSPICTOP.'S ORPICF .+,M,
I'
' CITY OF CUI LATINO
To
You are hereby authorized to connect the GAS service for''
Owner or Tenant
'At .... ..��.--.L.............
. New Service ---..------._..
•- . No. of Meters ..- -._:............ Reconnect .....................
... Move Service -----------_---------,-
No. of Add. Meters -------------- •. Move?Meter --------------------------
� '' tiPLUMBING INSPECTOR