512 (2) ao 4 7 PEP=F. m,FF LANE . 3
' — Lor No.
NO. STREET �-•• ,
4 LI TIC IKOR APPLIANCE PERMIT
p rr..
TY,OF:CUPERTINO
Date [.'961i k ., ± Permit No.
Fee S 1. 50
f'f�Y I1b
d Application Is Ity of Cupertino for a permit to install
Cr, 2:.i.
P gas appliances as listedon�there"vrse de;hereof, and agrees to install said
appliances in accordance with�the;.Proy�sions of the Plumbing rode of the City
Of Cupertipo, and all other.laT3s.applic III thereto.
Use of Premises . { I
5 Owner CONA'IONWEALTtT'B. I'M a_ Address #PLUMBING
-� —
Pd:gyf% 4 M, 9� ! t ', fid Address
CON�?.130 Pt_aG.lr7an oav ACTOK N`I"ti-09 Approved
roved
VQTaiCYJ�ID� {e ?7--:�:.`Q .'___`_` CTOa
Remarks (Check ✓)
Type of Appliance I Units Fees II New. Replace I Relocate
Gas Ranges I II I I
Wall Heaters
Gas Plat::
Circulating Heaters
Blower Furnaces I I=- x I I
Gas Fired Boilers''
Warming Ovens
Percolators I
Griddles- I -.Irkr. 11tx ( I '.
Steam Tables 9,�'�,I}I,11 r ,, IA�d:. •l,.
Gravi[y Furnaces� ;t�:' .+;"^ �r• , � r..k':.�. c
�r: l ,L,�a .II
Suspended.Unit"is;z•' p-'Ff,��'I:Irit..�
Floor Furnace " I=-A;; �1,4,;:�'^;�;,
Miscellarieous
NAME 1,TYP,E)
I I II II
• I I II I
pp lance Fees 1
Inspected and Approved .o?.J .�i/-' °��...."-"".."""-- ""....
[.
AT INSPECTOR
/j
GAS SERVICE NOTICE OF`..:E
3
BUILDING INSPECTOR'S OFFICE
i
CITY OF -CUPERTINO
u tF
a.
:. ....... G 1
To • '
III You are hereby authorized to connect the GAS service for
Owner or Tenant ---- .. ... ..
.... ..........
.T � :..-,•. J•r7.�.,.•:-; .�:� •aNew Service ..-C/...
No. of Meters .../.. ............'"'>. Reconnect .......... ....._........'`".,
S rM
` •.. :.F��.�Move Service -
;No. of Add. �eters .. .... . *. .;
MMo a Meter ................
'J PLUMBING INSZECTOR
Ls 110 1/60-500