886 GAS PERMIT/0756 I ��� LOT NO. 37
STREET
®t5 U� CATION FOR GAS PERMIT
CITY OF CUPERTINO
�Jp,N 11 1960
Date 1920 Permit No.
�VTY OF CUPERTIN Fee$ 4-
11�- Application is hereby made to the City Of Cupertino fora permit to install gas pipes
l)o and/or gas appliances as listed on the reverse side hereof, and agrees to install said pipes
lfl and/or appliances in accordance with the provisions of the Plumbing Code of the City
of Cupertino, and all er laws applicable thereto.
N ' ak
C
v
a
Use of Premises
n O/1/1/►'li Address
Bywn_W Address 0
(� o CONTRACTOR, AG 'P
Phone �t1� — q Approve
PL MBING INSPECTOR
Type of Appliance
I Units Fees II
Remarks (Check J)
New j Replace j Relocate
Gas Ranges j j jj
j j
1VVall` Heaters j j jj
j j
GasTUtes j j jj
j j
Circulating Heaters j j jj
j j
Blower Furnaces
Gas Fired Boilers j j
jj j j
Warming Ovens j j
jj j
Percolators
Griddles j j
jj j
Steam Tables j j
jj j
Gravity Furnaces j j
jj j j
Suspended Unit j j
II j j
Floor Furnace
Inspected and Approved -----------------!.
•----------
DATE INSPECTOR
HOUSE GAS PIPING
Number of Outlets j j Size of Main j
Gag�Piping Fees j
Tested and Approved ..-.....,t/ ...j. ..................
DATE INSPECTOR
.� D 73 to I �aiticZ�Lc�D'r�-C. Kai✓, LOT NO.-
NO. STREET
AP4�ICATION FOR GAS PERMIT
® OF CUPERTINO
D 9 195_ Permit No.
r r Fee $
CI TI-A�Pon � reb} TAQ 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.
OR a
°n Use of Premises
W -q
Q M
A Owner �N�-1--w G�t�-¢. - �. '� • Address —
v°� $ C4 By DIYISI Address
W w a EATINQC&TSW€ti0R rCO.
z 91497 5levwu Crwk Rd. Santa Clara,
Approved
c V Phone PLUMBING INSPECTOR
rte/
of Amliance I Units Fees II New
Xva11 Heaters
Gas Plates
/SD
iced Boi
Gravity Furnaces
Suspended Unit
Floor Furnace
Miscellaneous
NAME TYPE)
Inspected and Approved ............
D TE I INSPECTOR
HOUSE GAS PIPING
Nwnber of Outlets Size of Main
Gas Piping Fees
Tested and Approved I ...............................................
DATE INSPECTOR