742 - GAS PERMIT-0
%Z+� '' v LOT NO.
NO. STREET
o �. i�N FOR GAS PERMIT
OF CUPERTINO
® r16
Date T '195/
Permit No
•; ��?? �T�1Vv Fee $
�A�Alld ion is hereby made to the City of Cupertino for a permit to install gas pipes
and/or gas appliances as listed on the reverse side hereof, and agrees to install said pipes
and/or appliances in accordance with the provisions of the Plumbing Code of the City
of Cupertino, and all o r ws applicable Fe`fo.
v
C
Use of Premises
r-) 7
Owner zti Address-
BY,
ddress gy t Address
CONTRACTOR AGENT
Phone - v'Z Approved c
PLUMBING INSPECTOR
of Appliance I Units Fees 11 New
Wall Heaters
Gas Plates
Boilers
Warming Ovens
Percolators
Griddles
Steam Tables
Gravity Furnaces I ��
'Suspended Unit II
Floor Furnace
Miscellaneous
NAME TYPE) I I II
Inspected and Approved 1./d/.r:...
DATE INSPECTOR
HOUSE GAS PIPING
Number of Outlets Size of Main
Gas Piping Fees
Tested and Approved ------------- ------ -I......-----------------------------------------
DATE INSPECTOR
LOT NO. 3o
NO. STREET
S4jPL1TMIC
N FOR GAS PERMIT
tnyk,�_ "�`' OF CUPERTINO
Date 195_7_ Permit No.
5�
CITY OF CUPERTING Fee $ -
Application is hereby made to the City of Cupertino for a permit to install gas pipes
and/or gas appliances as listed on the reverse side hereof. and agrees to install said pipes
and/or appliances in accordance with the provisions f the Plumbing Code of the City
of Cupertino, and all other laws applicable ther
/ � ll
Use of Premises
Ow'STE et i
By 996 OPAL DRIVE
SAN JQBS4cC34LcW-0R
Ph, ..- PHONE: GH 34*d.4
Address
Address
Approve
PLUMBING INSPECTOR J
of Appliance I Units Fees
Gas
I Gas
Blower Furnaces
Gas Fired Boilers II
Warming Ovens
j Percolators
Griddles I�
Steam Tables
Gravity Furnaces I II
Suspended Unit II
Floor Furnace I I�
Miscellaneous I ii
NAME TYPE) I I II
Appliance Fees
Inspected and Approved ----=------------------ ----------------------------
DATE INSPECTOR
HOUSE GAS PIPING
Number of Outlets ( Size of Main I 3
Gas Piping Fees
Tested and Approved ...... - -.. .....................
DATE INSPECTOR
V
a
//r
��` e LOT
NO. STREET
C,��TION FOR PLUMBING PERMIT
CITY OF CUPERTINO
195 ' 1 Permit No.
T
' 1ppFF TT���� Fee $z
C ffypliQ on risU�'bVtflitde90 the City of Cupertino for a permit to install plumbing
pipes and/or fixtures listed on the reverse side hereof, and agrees to install said prices
and/or fixtures in accordance with the provisions of the Plumbing Code of the City of
Cupertino, and all othlaws applicable thereto.
� n n o
Use of
M
UMBING INSPECTOR
UNITS I FEES 11 1 UNITS I FEES
ater Heater
Hath "1 ubs I
I II I o Curb
Showers
To Prop. Line
—Lavatories
To Existing
Kitchen Sinks
Not Conn.
Dirh Washers
jI SEWER BOXES
Waste Disposals
I I II Size
Water Softeners
Bar Sinks I ` I II To Main Drain I I
Comb. Sink & Trays)
I II To Curb
Dental Units
I I II
TOTAL
Drinking Fountains)
I III
;Y::�ST:E::M—
RECORD OF INSPECTION
Floor Drains
I I II WATER
Hoppers
I I II Size
Restaurant Sinks
I I II Material
Sand Traps
I II TOTAL FEES
Urinals
I I II Fixture Fee
Area Drains
I I II Main Drain Fee
Water Leaders
I I II Storm Drain Fee
Sprinkler Valves
I I 11 Water Sys. Fee
ermit Fee
TOTAL
I II TOTAL FEE
RECORD OF INSPECTION
Partial Rough
Rough Complete
Final 'T
t