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Y;r Type of Appliance I Units Fees I New Replace Relocal
4� Gas Ranges
Wall Heaters
Gas Plates I I II
Circulating Heaters II I I
Blower Furnacesj
Gas Fired Boilers I II
Warming Ovens II I
Percolators jl
.Griddles
Steam Tables
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—ty Furnaces I aMr I
` $ nded Unit I II
Floor Furnace I I IS
I II I
Miscellaneous o
NAME TYPE)
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I I I I
pp lance Fees z �—
Inspected and Approved z.r. .l. ._'�. _......._ ........_-...---- ---...---
DATE. INSPECTOR
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