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APPEICATIOWFOR APPLIANCE PERMIT
�� I FEB 2 8 1964 CITY OF CUPERTINO
DateFEB 18 1964 A-3Z
----• • •• 19G...-. Permit No.
r'_.Y UV Ulll'- K 7`'
Fee $
m 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.
u
Use of Premises RESIDENCE
u 960 CAMDEN AVE.
Owner INLAND EMPIRE DEV. _ Address CAMPEJELL. CALIF.
By MERCURY SHEET METAS Address 8I G VE., MT. VIEW
CONTRACTOR, AGENT c'
Phone 139-4223 Approved
PLUMBING INSPECTOR
Remarks (Check ✓)
Type of Appliance Units Fees I New I Replace Relocate
Gas Ranges
'Wall Heaters
Gas Plates
Circulating Heaters
' Blower Furnaces I �I
Gas Fired Boilers
Warming Ovens
Percolators I II
Griddles
Steam Tables
Gravity Furnaces
Suspended Unit _
Floor Furnace
Miscellaneous
(NAME. TYPE)
I I u I
I I II I
0
Appliance Fees
Inspected and Approved . .E. . r. ..... ......................
r DAT INSPECTOR