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997 GAS PERMIT/© a Q LOT NO. - NO. ' STREET YV JRL : ,TION FOR GAS PERMIT 0TY OF CUPERTINO /MAY 18 9960 V Date 19iLL CITY OF tUPERTINO Permit No. 47 T/ 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 Owner 2:31Y bW4 By. 7V If CONTRACTOR, AGE Phone L — B C tl- Address Address Approv PLUMBING INSPECTOR Type of Appliance Units Fees Remarks (Check 0 New j Replace Relocate Gas manges Wall Heaters Gas Plates Circulating Heaters I �� Blower Furnaces Gas Fired Boilers �I Warming Ovens Percolators Griddles Steam Tables Gravity Furnaces I �I Suspended Unit II Floor Furnace Miscellaneous � � i� � � NAME XYPE� I I II Appliance Fees Inspected and Approved -------------------------- DATE INSPECTOR HOUSE GAS PIPING Number of Outlets Size of Main Gas "iping Fees Tested and Approved.. VAT .... ........... .................... INSPECTO