160:i.
10
IAPJ LICATI�
FEB 2 8 1964
LOT NO. L�2,-/
APPLIANCE PERMIT
L.7W.Lr11241t el
Date B 1 1964 196..... Permit No.— g -ro.
1
CI 17 Fee S �, 60e
Application is hereby made to the City of Cupertino for a per It 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.
Use of
RESIDENCE
Owner INLAND FMPIRF DFV _
By MERCURY SHEET
CONTRACTOR, AGR
Phone 739-1293
960 CAMDEN AVE.
Address --CAMPBELL, CALIF
AddresX AV�rE AVE. MT. VIEW
Approved
PLUMBING INSPBLTOR
Type of Appliance I Units Fees
Remarks (Check ✓)
I New Replace Relocate
Gas Ranges
Wall Heaters
Gds Plates
Ci;ailating Heaters
Blower Furnaces
Gas Fired Boilers
Warming Ovens
Percolators
Griddles
Stearn Tables
Gravity Furnaces
Suspended Unit
Floor Furnace
,Miscellaneous
NAME TYPE)
Appliance Fees (
, It
Ipspected and Approved... 4; .......GL ..................
DAT. INSPECTOR