497 (2) c o3 l� r bN,IA W
LOT NO. O
NO. � STp-,LET .� .._.
APPLICA 101 FOR APPLIANCE PERMIT
1951
l JUN 6 195 M.OF CUPERTINO
a /Date !_ .Y Gry�: _- 196----- Permit No.
Fee S-` 1
Appli'c'ation is hereby made to the City of Cupertino for a permit to install
gas'ippl'4i es as listed on the reverse side hereof, and agrees to install slid
appliances to accordance with the provisions of the Plumbing r-.ode of the City
of Cupertino, and all other laws applicable thereto.
u - a
Use of Premises
ee
r Owner J G� t C Address
.• -..ABY Address RC' COAANY
>,,_ a C NTRACTOR, AGE" ct N VAI
bio.
tone- Approved PLUMBWG INYPBCT A
B
Remarks (Che ✓ Lit '
Typo';of Kppliance I Units Fees II New I Replace ate'
Gas R'a'nges L,
Wsll eaters I I-x T
Gas Plate 'I
Circular" Heators�'
•Blower Fgrnaces;-
Gas Fir,egaBoilers"
Warming Ovens,
Percolators - II
Griddles
steam Tables
raGily Furnaces awl—w'
usPended Unit
Floor
Miscellane us I '.1� it t� � •-���'?
(NAME TYPE) I I I tj
�!f
PP Lance t ces I 1 It m
Inspected and Appraved nnre �.
I .,. LNsvecioa
£. .... ,
yrs