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11081 1 Bubb Rd,
NO. STREET
.'?JAN
R,
JAN 16 1968_'
Date 196_
LOT NO. 2
APPLIANCE PERMIT
CUPERTINO
Permit No.
CITY (?F (UPRTINJ(� Fee $
App kation is ere ,v made o 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
Code of the City of Cupertino, and all other laws applicable thereto.
Use of Premises R P C i rl Pnr a
Own
Ditz-Crane
,.y �Z7 f4lL AL Co.
By130 5_ Gihen Lye -FR 8-093
Phone
Cit��liA' CGrii�arnia
—
STATE CONTR CTOR'S
State License
L� x
N
Address P.O. Box 509 S. J,
Approved
PLUMBING INSPECTOR
Type of Appliance Units Fees II
Remarks (Check ✓,
New I Replace I Relocate
Gas Ranges II
1 1
Wall Heaters 1
I I
Gas Plates I I II
I I
Circulating Heaters I
I I
Blower Furnaces 1 11.0011
I I
Gas Fired Boilers I
Warming Ovens I II
1
Percolators
Griddles I I
1
Steam Tables I I II
1
Gravity Furnaces
Suspended Unit I it
1
Floor Furnace I II
I
I
I I
Miscellaneous
NAME TYPE)
19 2.2e II
I .Z 12.011
I
I IL 14.0011
1
I 1 12.011
I
I I II
I
Appliance Fees ,z�
F ------ F—
Inspected and Approved ............
DATE. INSPECTOR