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reea.nst.wa;;Z1.NO. STRUT l
APPLICA `- OR APPLIANCE PERMIT o
CITY,OF CUPERTINO
Date (6/29/60p'
196.._.. Permit No.
1 Wo 'e t•., g0
,f'1r Fee $
. ATifaTonfi,�her�b �EdRTlt ity of Cupertino for a permit to,install
gas app jances as Isted on t e,reverse side hereof, and agrees to install said
appliances in accordance with'the provisions of the Plumbing r•,ode of the City
_ of Cupertino, and all other laws applicable thereto.--.
5 ,.. .,,
Use of Premises RGs
r7i Owner Vannisrnric+r-, Address P •0 BOX 3307
SAN.CARL Address yvuard
R AGENT
779. OLD COUt"F1W'rRU.�1B ' A roved rzz
°�' SA1t695, EAFI(6RPdIA PP PLUMBING INSPECTOR
Units' F� Remarks (Check ✓)
Type of Appliance I ees II New I Replace I Relocate
G+ as Ranges
Will Heaters
Gas Plates
Circulating Heaters
:Blower Furnaces
Gas Fired Boilers
Warming O ens
Percolator
=eases/
' Suspended Unit II
Floor Furnace I ■
Miscellaneous
NAME TYPE) I
I I I II I
Appliance I�
—Inspeced and Approved ] AT..F... /y
.............
INSPECTOR
.....
er,
GAS d r 01
` OFFICE
SER
BUILDING iNSPLS• dprI1 COPY^ + `
,, F
'fir+^yCITY OF CUPS
K� To r rt, r. . t2�+
You are hereby authorizedto connect the SGAservice for. -
Ownet'or'Tenant ....r =.. ...f.f?<!% ......:.!/./Q....—
+ A ;. �Q T ._ ......( . GC ..: �i��% e
New Service -----------
No: 'f Meters ........ ., Reconnect,
. .Move'Scrvice :..s.-.:--_r.-:^:...,
No.'of'Add. Meters .............. Move Meter .-_::..:...:..-..-.-
- '!.
-----------
PLUMBING'.iNSPECTOR
�` :110 6/59-500 .