866 (2) A A IL.0% Lor No. 23.
No. STREET Tract #2880
A PL I OR APPLIANCE PERMIT
® C F CUPERTINO /
Date 6..... Permit No._ g64 _
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P�l P h'�rrE81.4MO Fee s Z —
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N A c do he Gty of Cupertino for a permit to install
ogas appliances as listed on the reverse side hereof, and agrees to install said
Happliances in accordance with the provisions of the Plumbing rode of the City
of Cupertino, and all other laws applicable thereto.
Use of Premises
Res .
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iZlf Owner Thomas CoMtr _ Addres�59 mDt, ll Av
` CBARLOSSHEET METAL W scam bel
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gAN CAR OStO —i & �Aeerr PP
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Phone
PLUMBING INSPECTOR
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Remarks (Check ✓)
Type of Appliance I Units Fees II New Replace RelOCate
Gas Range— s
Wall Heaters
Ga;—Plates
Circulating Heaters ���
Blower Furnaces 1 1 Sol X
Gas Fired Boilers � � �� � � -
Warming Ovens
Percolators �—
Griddles
Steam Tables _
Gravity Furnaces IL_
Suspended Unit
Floor Furnace
Miscellaneous
(NAME TYPE)
Fiancee ees —��—
In}petted and Approved ..............: .. . .... .
..... .........
DATP. .������� ��INSPa(T'O0.