987 (2) F 0 3 Off- LOT NO.
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r2APPL_ICATION FPR APPLIANCE PERMIT
CrW, OF CUPERTINO
Date QCT. TIM M ' 196..._ Permit No.����`��
a A Y Fee S
c ppii attor is hereby made to tie City of Cupertino for a perm,t to ipgv U 1,
gas appliances as listed on the reverse side hereof, anc.;Lm_s tc irstaH ca'
app.rances'in accordance with the ptovisioas City
of Cupertino, and all other laws applicable thereto.
Use of Premi
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DIVOO - nacres .
sth I 11NU & b ` ,ENT .
180 a, SONNYBAKS AVE., CAMPBELL, CALIF. Approved
Ff:one
PLUAtaING INSPaC70
Remarks (Check ✓)
-T;Ipe of Appliance I Units Fees II New Replace Relocate
Gas' Ranges 11 11
Wa6 Heaters 19
Gas" PlatesI
Circulating Heaters
Blower Furnaces
Gas Firecl Boilers
Warming Ovens
Percolators
Griddles
Steam Tables
Gravity Furnaces
Suspend Unit--��_—!II �. —
Floor Furnace
Miscellaneous
(NAME TYPE) I II I
�'pp lance ees !� Ua
Inspected and Approve a{ .I. ........
OATH INSPECTOR