1146 (2) i Ci l I a I LOT NO. 6
NO. STREET rac
APPLIANCE PERMIT
C (�F CUPERTINO
I if 111963
Date 28/63 196..... Permit No.
co CITY OF CUPERTINO Fee $ ( —
Application is hereby made to the City of Cupertino for a permit to install
H gas appliances as listed on the reverse side hereof, and agrees to.install said
appliances in accordance with therovisions of the Plumbing g ode of the City
of Cupertino, and all other laws applicable thereto.
x
Use of Premises Res.
OwnerCu�ertino Prop Ltd Address o
2 M tree St.
A OS SHEET METAL WORKS, INC. —
a 'i s c
&A oNTgncTo nceNr
Address'S F
�2 Approved
0-4- PLUMBING INSP OI
Remarks (Check ✓)
Type of Appliance I Units Fees II New I Replace I Relocate
Gas Ranges I II �—
Wall Heaters 1 I
Gas Plates
Circulating Heaters_
Blower Furnaces 1 1 1 501
Gas Fired Boilers 1 1 11
Warming Ovens I I II
Percolators
Griddles I I II I
Steam Tables I I
Gravity Furnaces
Suspended Unit11
r Floor Furnace
Miscellaneous
(NAME TYPE) 1 1
1 Fee I 2.odl_ I
11 0 a s I 12. 7011 _�
1 Gas out I I .5011 —
I II I
pp lance eek 1 6.7$1
Inspected and Apprdved5.. .-;3...1...... ............................
DATE. INSPECTOR
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