1230Qo
�9
m,
T
LOT .
O. EET
?/JAN
'14thTION
OF
Date 11
195
FOR GAS PERMIT
CUPERTINO
Permit No.
CITY F CUPERTINO 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 of the Plumbing Code of the City
of Cupertino, and all other laws applicable thereto.
Use of
Owacr
By CONTRACTOR, AGEN'1�
Phone
Address
Address 516 %
Approved -WILLIAM �
PLUMBING INSPECTOR
Type of Appliance
I Units Fees II
Remarks ( Check J)
New Replace Relocate
Gas Ranges
Wall Heaters
GA Plates
Circulating Heaters
Blower Furnaces
Gas Fired Boilers
Warming Ovens
Percolators
Griddles
Steam Tables I
��
Gravity Furnaces
Suspended Unit
II
Floor -Furnace I
��
Miscellaneous � �
i�
NAME TYPE) I I
II
Appliance Fees
Inspected and Approved ------------------!.......
DATE INSPECTOR
HOUSE GAS PIPING
Number of Outlets Size of
Gas Piping Fees
Tested and Approved .. ........... TE INSPECT R
ye? C/ 1/ La- LOT ND/
No.I ��' '
t1,ACPPERTlNO PLIANCE
�s EB ssi 1TrJ.11
Date 196 ..... Permit
CITY C'- CUP'JINO
PERMIT
No. %
Fee $ S�
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 rode of the City
of Cupertino, and all other laws applicable thereto.
Use of Premises '
OwneAddress _
By Address
`!G & SHEE'RM' AfTe@ AGBNI Approve
PL0110)AKS AVE GAMPRE1 I CA] I E L
- PLUMBING INSPBCTOR
kNew
Remarks (Check 0
Type of Appliance Units Fees j Replace j Relocate
Gas Ranges j jj j j
Wall Heaters j j jj j j
Gas Plates
Circulating Heaters j j jj
j j
Blower Furnaces j ! T7777jj
Gas Fired Boilers j j
Warming Ovens
Percolators
Griddles j j
jj j j
Steam Tables j j
ij j j
Gravity Furnaces
Suspended Unit j
II j
Floor Furnace
Aiisceitaneous
NAME TYPE
nppuance rees I
Inspected and Approved
__T,e
Nb. VIVEET
'/J�lt TION FOR GAS PERMIT
OF CUPERTINO
� JAN 11
r\ Date 195_ Permit No.—I
o �=
CITY C'= CUPERTINO Fee $
y
m
H
C
v
v
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 of the Plumbing Code of the City
of Cupertino, and all other laws applicable ther o.
F V l
Use of Premises
Own
By
CONTRACTOR, AGEN-P
Phone -& i - f -i 8 O —T
PLUMBING
'_�
of Appliance I Units Fees 11 New
Wa11 Heaters
Gas Plates
Circulating Heat
Bl Ewer Furnace!
Gas Fired Boile
Warming Oven;
Percolators
Griddles
Steam Tables
Gravity Furnace
Suspended Unit
Floor Furnace
Miscellaneous
(N'AME TYPE
Appliance rees I
1 11 1 1
Inspected and Approved
................................................................
DATE INSPECTOR
HOUSE GAS PIPING
Number of Outlets
Gas o
Size of Main
Piping Fees
i Q.rlp�
Tested and Approved
.............
DATE INSPECTOR
i
C L Q eq r" �c��—n JN r ---
LOT N
NO. SUBET '
Ar�fFEA9§-j
PJ '-'--bik"APPLIANCE PERMIT
CITY CUPERTINO
Date 196 ----- Permit No. 4-2-C)
CITY F- CUPERTINO Fee $. t , �
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 rode of the City
of Cupertino, and all other laws applicable thereto.
Use of Premises
Owner' / r 4�Address —
'IV
gy Address
ACTOR AGENY�
H ' '^ & SHEET METAL Cb. Approv
ISO B , PLUMBING INSPECTOW
Type of Appliance
Gas Ranges
TY/all Heaters
Gas Plates
Circulating Heaters
Blower Furnaces
Gas Fired Boilers
Warming Ovens
Percolators
GriWes
Steam Tables
Gravity Furnaces
Suspended Unit
Floor Furnace
Miscellaneous
NAME TYPE)
Units Fees II New 1 Replace I Relocate
Appliance Fees � �-'
Inspected and Approve d���- .. "A
D T . COR
V
m
J
r
v
v
)I ".-Akk-u
Li STR �, .
APPA ION FOR GAS
JAN 11 11; `� OF CUPERTINO
LOT N
A'�C'q.r
PERMIT
D6 195_ Permit
No.
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 of the Plumbing Code of the City
of Cupertino, and alltheerlaws applicable thereto.
lo a�
Use of Premises_
Owner
By
CONTRACTOR, AGENT
Phone Z'Z'� — X -Y 8 U
Address `IG 74!%44404-4)
Approved WILLIAM S
PLUMBING INS EV/CH
of Appliance I Units Fees 11 New
Wall Heaters
Gas Plates
Ciirculating Heaters
Blower Furnaces
Gas Fired Boilers
Warming Ovens
Percolators
Griddles
Steam Tables
Gravity Furnaces
Suspended Unit
Floor Furnace
Miscellaneous
NAME TYPE)
Inspected and Approved ------------------
- DATE INSPECTOR
HOUSE GAS PIPING
Number of Outlets Size of a'n
Gas Piping Fees
Tested and Approved .... ..................... ................
I)ATE INSPECTOR
-:�o �/o 0
NO. rt SgREB
.ICAT�?
FEB 6 ,{,�
LOT NO.
OR APPLIANCE PERMIT
OF CUPERTINO
Date CI F E B , ,t _ . ' ��Q6-----
Permit No. C '
Fee 1
7�0—
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 rode of the City
of Cupertino, and all other laws applicable thereto.
Use of
Owner e `��� Address _
By Address
lY G`O TRACTOR, AGENT
fl
H T?NG & SHEET METAL CO. Approved
180 Z. PLUMBING INSPB
Remarks (Check 0
Type of Appliance I Units Fees II New 1 Replace I Relocate
Gas Ranges
—\Y/AFHHeaters I ��
Gas Plates
Cirnilating Heaters I ��
Blower Furnaces
Gas Fired Boilers
Warming Ovens
Percolators
Griddles
_
Steam Tebles
Gravity Furnaces
Suspended Unit
II _
Floor Furnace
Miscellaneous
NAME TYPE i I
II
II
II
Appliance Fees T�� -'—�—
Inspected and Approved.1.. -
DAT- CTOR
-7L ;?e fes! -f LOT NO.
NO. STREET
APPLICATION FOR APPLIANCE PERMIT
r CITY OF CUPERTINO
Date_ _ __ 196..... Permit No.
CITY C r��!P�QT1Nr) 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 rode of the City
of Cupertino, and all other laws applicable thereto.
v
C
v
Use of Premises_
v
ZZ
l� Owner
By I
.L HEATING & SH!°W, 'i^crpn�ecEN'P
Address —
Address
Approved
i, LAI
PLUMBING INSPECTOR
Remarks (Check 0
Type of Appliance Units Fees II New Replace Relocate
Gas Ranges
Wall Heaters
Gas Plates
Circulating Heaters I ��
Blower Furnaces
Gas Fired Boilers I �I
Warming Ovens
Percolators
Griddles
Steam Tables
Gravity' Furnaces
Suspended Unit 1
II
Floor Furnace
�1CfPI I-1 f1P111C I I
!I I
•
Permit No.
v0
Fee $-4;2
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 of the Plumbing Code of the City
of Cupertino, and all other y , laws applicable thereto.
Use of Premises /t�`� /
Owner
By
CONTRACTOR, AGEN'P
Phone � 4 1 1r`1 ¢ o
WILLIAM D. BAEVJ
PLUMBING INSPECTOR
of Appliance I Units Fees 1i New
Wall Heaters
-Gas Plates
Heaters
Furnaces
nit
Miscellaneous
NAME TYPE)
Inspected and Approved ----- - ----------t -
DATF INSPECTOR
HOUSE GAS PIPING
Number of Outlets Size o Nuin
Gas. Piping Fees
Tested and Approved -a ........ ......... ........................
DATE INSPECTOR
GAS SERVICE NOTICE OFFICE
COPY
BULIDING INSPECT'OR'S -OFFICE
CITY OF CUPERTINO
...... I .......... .......196
-------- ---
..............
To
You are hereby authoriz I to connect the GAS service fo
c
Owner o T ant ............... .... .. ............ ----- -- - - ---------- ------ -- --- ---
--------------- --------- ..... ... ........................ ..... ............ ------ ------
-------------
.... ..... ... .. . ................
At ...... . . .......... Z) .......... .....
New Service ..... ........
No. of Meters ------- --------------- Reconnect ..............................
Move Service ........................
No. of Add. Meters .............. M ter ..........................
4
................... ---- -- -- ----- -
(�r
ku ... BINING ... ... S'P'E"TOC'
110 1/60-500
L' '4f�Ct 'i E �C - 1� ��-�-/ LOT No(-Z!��
NO. STREP.T
APPLICATION FOR APPLIANCE PERMIT
}' "y CITY OF CUPERTINO
2 1961r
Date ,- 1i6.._. Permit No.
Fee S — -
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 rode of the City
of Cupertino, and all other laws applicable thereto.
Use of Premises_ c�
cit Owner `� _'� Address —
gY Address
bKE T'NG SH �%Q'GEN'�
�Appro
yy(pKc PVFAMPL H�t:� ve PLUMBING
G lNSPECTOH
Type of Appliance
I Units Fees II
Remarks (Check. J)
New ( Replace Relocate
Gas Ranges
will Heaters
Gas Plates I
��
Circulating Heaters
Blower Furnace / 5 ��
�� ✓
Gas Fired Boilers
Warming Ovens
Percolators
Griddles
Stearn Tables
Gravity Furnaces
Suspended Unit
II
Floor Furnace
Miscellaneous
NAME TYPE
II
Appliance Fees
Inspected and Approver.^.�
D FMbi,.C-TOR
)f/1
JAN 1#M'6j :ON FOR GAS
CITY OF CUPERTINO
LOT
PERMIT
DaXITY C'-- CUPERTING195_ Permit No.
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 of the Plumbing Code of the City
of Cupertino, and all other laws applicable thereto.
Use of
Owner A
By A
CONTRACTOR, AGENT
Phone - f V e v A
i
Im
X16 ,A
of Appliance I Units Fees 11 New
Gas Ranges
Wall Heaters
Gas Plates
Circulating Heaters
Blower Furnaces
Gas Fired Boilers I ��
Warming Ovens
Percoyiors
Griddles
Steam Tables
Gravity Furnaces
Suspended Unit II
Floor Furnace
Miscellaneous
(NAME TYPE) I 11
nppilance tees I 1 II 1 1
Inspected and Approved ...............
.... !...............................................
DATE. INSPECTOR
HOUSE GAS PIPING
Number of Outlets Size of M ;
Gas Piping Fees
Tested and Approved -------------
I)ATE - / ...- -- - OR
CIO
m
Q S H
PLI ION FOR GAS
J
AN 11 1 v tt...1 OF CUPERTINO
iv . I ► •
L •
LOT 7
PERMIT
Permit N
m�
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 of the Plumbing Code of the City
of Cupertino, and all other laws applicable thereto.
Use of Premises 1. V V l ""
Ow er Addre _
ByAddress -76yAzzadA� w
CONTRACTOR, AGENT WILL"
Phon'a-,�- � — � � � Approved � D• SPNEV'c;14
PLUMBING INSPECTOR
of Appliance I Units Fees 11 New
Gas
Gas Plates
Steam
Gravil
Floor Furnace
Miscellaneous
NAME TYPE)
Inspected and Approved
DATE INSPECTOR
HOUSE GAS PIPING
Number of Outlets Size of Main
Gas Piping Fees
Tested and Approved ---- - - -----
TATE INSPEC OR
GAS SERVICE NOTICE OFFICE
COPY
$UILDID7G INSPECTORS Or'FICE-
CITY OF CUPERTINO
..�........................ 1961 ---
You are hereby auth 'zed to connect the GAS service for
Owneror Tenant ------------------- _--..-.-.-.......----•--------•---•--•------------ ........
.. o... Q--�.....-.-�.... - ._........._
At .... /
New Service ......... .............
No. of Meters ........................ Reconnect ..............................
Move Service ........................
No. of Add. Meters..............o Meter ..........................
........ .. .- .......
---y....
--y .. ..
PLUMBING INSPE
110 1/60-500
I
1 LOT DIV
NO. STRHET
APPL4QATIQN FOR APPLIANCE PERMIT
h . CITY OF CUPERTINO
1 1961/Z
-del—
Date�Es 96____. Permit No. _
Fee $
CITY l
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 rode of the City
of Cupertino, and all other laws applicable thereto.
Use of Premises_
Owner Address _
By Address
YYYW WOR, AGENT
Approve
Ph8 ATFL► (' j, sW��C,r PLUMBING INSPECTOR,
80 E. SUNNYOAKS AVE.. caMPPPii ���.�
of Amliance I Units Fees
Gas
Blower Furnaces
Gas Fired Boilers
Warming Ovens
Percolators
Griddles
Steam TsIbles
Gravity Furnaces
Suspended Unit
II
Floor Furnace
IMM-Cndncoub
(NAMF TYPE
Inspected and Approved ------------
n T. INSPECTOR
I-z-
m
a
V
v
A
PP TION FOR GAS PERMIT
trf JAN 11 I'J 'CITY OF CUPERTINO
(q1� t `- P F, T IR N 0— 195_ Permit NO. �
V 1� p (:
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 of the Plumbing Code of the City
of Cupertino, and all other laws applicable thereto.
f t
Use of Premises
Ow r
By
CFNTRACTOR, AGEN'P
Phone - s 79 q C)
Address
Address SL6 7 Lr/�1
ApprovedWILLIAM D. BEN
PLUMBING INSPECTOR
Type of Appliance I Units Fees II
Remarks (Check J)
New Replace Relocate
Gas Ranges
Wall Heaters
Gas Plates
Circulating Heaters
Blower Furnaces
Gas Fired Boilers
X -Harming Ovens
Percolatgrs
Griddles
Steam Tables
Gravity Furnaces
Suspended Unit
II
Floor Furnace I
��
Miscellaneous � � ii
(NAME TYPE) I I II
Inspected and Approved --- ------------------------------------------- ----------.
DATE INSPECTOR
HOUSE GAS PIPING
Number of Outlets I Size of ain
Gas Piping Fees
Tested and Approved j... .1 ......... .. .......................
TATE INSPECTOR
�o
t
V
c
v
Ti
a B
AQ -
q��PLI ION FOR GAS PERMIT
?JAN 11 1 got OF CUPERTINO
De r- 191__ Permit No.
1, 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 of the Plumbing Code of the City
of Cupertino, and all other laws applicable thereto. AI a
Use of
6
OvRier A
By al A
CONTRACTOR, AGENT
Phone � - S o A
44L 7
WILLIAM
PLUMBING INSPECTOR
Remarks (Check �7)
Type of Appliance I Units Fees II New I Replace I Relocate
Gas Ranges I I II
wa11_Heaters I I II
Gas -P- s I I II
Cir2ating Heaters I I II
Blower Furnaces I I II
G ti Fired Boilers I I II
Warming Ovens
Percolators
_Griddles I I II
Steam Tables I I II
Gravity -Furnaces I I II
Suspended Unit I I II
Floor Furnace I I II
__
Miscellaneous
(NAMI TYPE)
Appliance Fees
Inspected and Approved ----------------!............... ........
DATE INSPECTOR
HOUSE GAS PIPING
Number of Outlets I 1..1 Size of Main 1
Gas, Piping Fees I 1
Tested and Approved ------.
TATE INSPECTOR
J /
LOT N
LJA�
NO. STREET
APPL , ?s Ei °�fi4fi A I*PLIANCE PERMIT
CI'IF L
ERTINO /
F E B � Z1'��
Date 196..... Permit No.
CITY C CUPERTINO Fees l�
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 slid
appliances in accordance with the provisions of the Plumbing rode of the City
of Cupertino, and all other laws applicable thereto.
1 4/ eql >
Use of Premises
y
.�1 HEATING & SME fi"M t!Pr
�1
_ Address —
' Address
Approved
PLUMBING II�SPBCTO
Type of Appliance
I Units Fees II
Remarks (Check t7)
New Replace Relocate
Gas Ranges
Wall Heaters
Gas Plates
Circulating Heaters
Blower Furnaces
Gas Fired Boilers
Warming Ovens
Perco ators � � j�
Griddles
Stem Tables
Gravity Furnaces
Unit
S -
Floor Furnace
Miscellaneous
NAME TYPE I
II
I�
Appliance Fees c
Inspected and Approved .--- (-...'�.-. )—c - •---•--••------
DATE INTOR
50
_ 1
O T
P TION FOR GAS
JAN 11 1'�I� I ITY OF CUPERTINO
LOTdt,
PERMIT
'Te '_ 195_ Permit No.
Fee $ f
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 of the Plumbing Code of the City
of Cupertino, and all other laws applicable thergto. A n
Use of
BY
Ph
CONTRACTOR, AGEN'P
Address
Address SLG 7 Ze-l-Af4-4) Uld—
Approved WILLIAM D. BENEVI
PLUMBING INSPECTOR
of AmAiance I Units Fees II New
Gas Ranges
\ all Heaters
Gas Plates
Furnaces
Gas F
Griddles
Steam Tables
Gravity Furnaces
Suspended Unit
Floor Furnace
Miscellaneous
NAME TYPE)
Inspected and Approved ...... _ ;....
DATE INSPECTOR
HOUSE GAS PIPING
Number of Outlets Size of Main
Gas Piping Fees
Tested and Approved ........ ..-• ... . . ....................
?)ATE INSPECTOR
LOT
No. STREET
APPLICATION FOR APPLIANCE PERMIT
CITY OF CUPERTINO
F�FFEEk X61 19 Z b
Date__—_ 196..._. Permit NO.
CITY F �,UPFPTINO 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 rode of the City
of Cupertino, and all other laws applicable thereto.
v
Use of Premises-_
Owner Address—
By Address
fr--� -
ACTOR, AGENT A COV
"y AGOG & SHEET METAL' CO. PP ~
lAf F ` PLUMBING INSPECTOR
Remarks (Check: d)
Type of Appliance Units Fees II New j Replace Relocate
Gas Ranges
Wall Heaters
Gas Plates
CircWating Heaters I I�
Blower Furnaces
Gas Fired Boilers
Warming Ovens
Percolators
Griddles
Steam Tables
Gravity Furnaces
Suspended Unit
II
Floor Furnace
1V1ibLC11j"11C0LL3-
(NAMF TYPE
Appliance tees I I II I
Inspected and Approved -F ...........................
DATE - INSPECTOR
O. 5 "a
ION FOR GAS
AN 11 101 OF CUPERTINC
n
�o
0
H
C
V
f LOT N
•?ERMIT
Date195_ Permit
CITY C'= CUPERTINO
No.
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 of the Plumbing Code of the City
of Cupertino, and all other laws applicable thereto. n
Use of Premises (b t AA -.'--.a
Address -1-6 % w ce
Anoroved WILLIAM
PLUMBING INSPECTOR
of Appliance I Units Fees II New
Gas Ranges I I II I i
Wall Heaters
Gas Plates
Circulating Heaters
Blo—er Furnaces I ��
Gas Fired Boilers
Warming Ovens
Pecc�ators
Griddles
Steam Tables I I II I I
Miscellaneous i r
NAME TYPE) I I II
Inspected and Approved ..............:..
DATE INSPECTOR
HOUSE GAS PIPING
Number of Outlets I Size o( Pkin
Gas Piping Fees
Tested and Approved ... -. `K?..: ... .......................................
Y)ATE INSPECTOR
LOT NDKIT
NO. MEET
APPLICATION, FOR APPLIANCE PERMIT
a t:ITY OF CUPERTINO
Date 196 ----- Permit No.
CITY. C WHERTING Fee s —
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 rode of the City
of Cupertino, and all other laws applicable thereto.
Use of Premises—a�"k - �
QF
Address— 1PLUIBING,
Address _Approved
CI
of ADoliance I Units Fees II New
Gas Plates
Circulating Heat(
Blower Furnaces
Gas Fired Boiler
Warrring Ovens
Percolators
Griddles
Steam Tables
Gravity Furnaces
Suspended Unit
Floor Furnace
Miscellaneous
NAME ,TYPE
Inspected and Approved -'.-.1.j ..........................
DATE INSPECTOR
p s
APPLI, O
N FOR GAS PERMIT
AS PERMIT{JAN 11 19, OF CUPERTINO
D ITY F CUPERTIRG, 195_ Permit No. l's
Fee $ ;;f- �
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 of the Plumbing Code of the City
of Cupertino, and all other laws applicable thereto.
Use of
v� Own r A
By A
t ,,f' CONTRACTOR, AGENP
Phone 14 IZ $ y Al
1,67 Lc%G
WILLIAM
PLUMBING INSPECTOR
Type of Appliance
I Units Fees II
Remarks (Check J)
New Replace Relocate
Gas Ranges
Wall Heaters
Gas Plates l I
I
Circulating Heaters
�)
Blower Furnaces
Gas Fired Boilers
Warming Ovens
Percolators
Griddles
Steam Tables
Gravity Furnaces
Aed Unit
Furnace
NAME TYPE
Appuance rees I 1 II 1 1
Inspected and Approved ..... ....... .�
DATE INSPECTOR
HOUSE GAS PIPING
Number of Outlets Size of Main
Gas Piping Fees
Tested and Approved ".'YQr...------..... ..................
t1ATE INSPECTOR
lu
v
1.O
L�)��n y�iC c1:LE" d i� � E_ LOT N
NO. STRB
APPLICATION FOR APPLIANCE PERMIT
C, GITY OF CUPERTINO
6
Date - Permit No.
�( `P� RT Fee S —
Ap}i41IRn is here lf►ade tO t�e`�C�`lty 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 rode of the City
of Cupertino, and all other laws applicable thereto.
Use of Premises
y
Owner `� '-kddress - By DMMAddress_- _ -
ACTOR, AGENT Approved
M,j;jNG & SHEET METAL : PLUMBING 1NSPECTO
SUN YOIU AKS AVE., CAMPBELL, CALIF,,,
Remarks (Check J)
Type of Appliance Units Fees I New Replace Relocate
Gas Ranges
Wall Heaters
Gas Plates
Circulating Heaters I ��
Blower Furnaces I ;' / O II
✓
Gas Fired Boilers I �)
Warming Ovens
Perccletors
Griddles
Steam Tables
Gravity Furnaces
Suspended Unit
II
_
Floor Furnace
1v11J1C11'd11CJ LLJ
NAME TYPE
Apptlance tees I I/ f" _ II 1 1,4% A I
Inspected and Apprcved_4:---..(.. ..
DATE INSPECTOR