885I o 7 ssa ( tt ti
N6: STREET
LOT NO. 3 ff
® 1 TION FOR GAS PERMIT
(j
11 9960
OF CUPERTINO
Date I /I , 19k v Permit No. _
CITY OF CUPFRTINO Fee $ s
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
Address
Address ��-
Approved
PLUMBING INSPECTOR
of Appliance I Units Fees I) New 1 Replace I Relocate
wall . Heaters
Gas Plates
Circulating Heat,
Blower Furnaces
Gas Fired Boiler
Warming Ovens
Percolators
Griddles
Steam Tables
Gravity Furnace!
Suspended Unit
Floor Furnace
Miscellaneous
(NAME TYPE)
ees
Inspected and Approved --------------- I
DATF INSPECTOR
HOUSE GAS PIPING
Number of Outlets Size of Main
Gas Piping Fees
ested -and Approved- • •-
DATE INSPECTOR
Q 7_S7r) I Wci� a,
LOT NO. -3d
NO. STREET
JuA. PIP4j.CATION FOR GAS PERMIT
111hi
CITY OF CUPERTINO
Dat �� 1g9 195_ Permit No. l?"Z
-% Fee $ —
�icatiAn is4.U"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.
e6
d Use of Premises
AM OwnerCt-w. Address
co 9 DIV
v, ,� C By DIVISION Address
B saa cw HEA TINCcc&TSWf6R�,JMAJ1CO.
1� 97 Stevens Creak Rd. Santa Clara CaR Pp
'� ow as Phbn� Approved
N
PLUMBING IN,
Type of Appliance I Units Fees II
Remarks ( Check V)
New I Replace I Relocate
Gas Ranges 1 I II
Heaters
_Wall
Gas Plates I I II
Circulating Heaters I I II
Blower Furnaces
Gas Fired Boilers I I II
I i
Warming Ovens
Percolators
Griddles I I
II
Steam Tables I I
II
Gravity Furnaces I I
II i
Suspended Unit I I
II
Floor Furnace I I
1 1
—lop
Miscellaneous I I
it
NAME TYPE) I I
II
I I
II I
II I 1
Appliance Fees ! s
Inspected and Approved �� . ... ...............
DATE INSPECTOR
HOUSE GAS PIPING
Number of Outlets 1 Size of Main
Gad Piping Fees
Tested snd Approved ........................ I...............................................
DATE INSPECTOR