1637E
1'�310 y 1 'O07s"- L ''/^ Iw- LOT NO.
NO. ^'STREET
71
T EET71
:jAPPL'"ICATIONFOR APPLIANCE PERMIT
l FEB 2 8 1964. CITY, OF CUPERTINO
Date FEB 18 1964 196..... Permit No.
C.',Y OF C'jrk F«s ,,
Application is hereby made to the City of Cupertino for a permit to install
tigas 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.
a Use of Premises
Owner INLAND EMPIRE DEV. _
13Y MERCURY SHEET METAL
CONTRACTOR, AG T
Phone 739.4223 —t
BBO CAMDEN AVE.
Address CAMPBELL, CALIF
Address 81 ALXE AVE., MT. VIEW
Approved_
PLUMBING INSPECTOR
Type of Appliance I Units Fees
Remarks (Check ✓)
I New I Replace Relocate
Gas Ranges
Wall Heaters
Gas Plates
Circulating Heaters I 1
II 1 1
Blower Furnaces I x`11
Gas Fired Boilers.
Warming Ovens
Percolators
�_ I
lGriddles
'Steam Tables
II 1
Gravity Furnaces
Suspended,Unit
Floor Furnace I
-
Miscellaneous
ii I
(NAME TYPE)
II 1
I e I sal
I
I I
II I
I I
II I
ApplianceFees
Inspected and Approved ._ S11.`} .'
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ATP. I INSPECTOR