689 (2) rJ LOT NO. #10
aT Idlewild #2880
�ebIFAT��OtNR APPLIANCE PERMIT
tt n OF CUPERTINO
DatePIT r; �PEpT1���U196..... Permit No. coS
tji �,Z
Fee$
Application is hereby made to the City of Cupertino for a permit to install
gas appliances as listed on the 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.
` Res.
Use of Premises
Rousseau Org. Ad��582 Market
Owner .
an r c St
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SAN CAIDS SWEET AAFTAI WoDvc lAIM Address
779 OLD COLlf, A)& AGe11'I'
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Remarks (Che V'Y
Type of Appliance—I Units Fees II New Replace 'Re ovate
Gas Ranges �� T
Wall Heaters
Gas Plates
Circulating Heaters
Blower Furnaces
Gas Fired Boilers
Warming Ovens
'Percolators —
Griddles II�
Steam Tables
Gravity Furnaces
Suspended Unit II
Floor Furnace
Miscellaneous
(NAME TYPE)
pp lance •ees _
Inspected and Approved .) .',.. ...
.. ...............................
p p INSPECT00.
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