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1104 (2) �'.��`-� I• _ "_ �_� O •• I�� LOT NO. No. sTRee'r - Tract #3248 APPLICATION-FOR APPLIANCE PERMIT 4 ;� CI y(OF CUPERTINO JA[I 1�- .u6� �- Date 119/63 t96__._. Permit No. j y= GIT f ,r'"E RT'Nf Fee S lO ?� . c, Application is hereby made to the City of Cupertino for a permit to install Go 0 gas appliances at listed on the reverse side hereof• ana agrees to install said appliances in accordance with the provisions of the Plumbing rode of the City of Cupertino, and all other ws applicable thereto. Use of Premises_ Rwa 05 Owner Camino Del Homes _ Address' 0 Box 6 SAN CARL 5 SHEET METAL WORKS,tNC. CUD ti y I +` N ncr a, ncRNr Address Approved Q PLUMBING INSPB R Remarks (Check ✓) Type of Appliance I Units Fees II New I Replue Relocate Gas Ranges Wall Heaters Gas Plates Circulating Heaters Blower 'Furnaces 1 1. Ol F �+ Gas`Ficed.Boilers Warming..",Ovens Percolators I I � Griddles:.. II �— Suspend Floor- urnace: — Miscellaneous I ' (NAME TYPE _ Fi+eB iz-(](]Ili I ra4 n + I _ KnNit- IL I _ I II pp +ante ees eiat t Inspected and Approved . ...... ........�X.... .... ... .................... DATE. uys ECT00.