51167.2_Appliance Application21891 (Columbus Avenue LOT NO. #1
NO. STREET `
APPL10j%140N;rF0R APPLIANCE PERMIT
�' 9
j 2 4,14P F CUPERTINO
Date _ AY 13 1968 116 Permit No.y` ��L� i• Z
Fcc4 /3 2S
AppliCatti-51 .is fieceBFM8e,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
Code of the City of Cupertino, and all other laws applicable thereto.
Use of Premises Residence
Owner Ditz-Crane Address
Plo g Sheet Metal
J Z Dy
J'O CONTRACTOR, AGENT
- Phone. < 8-0 4
Z
a o State License #142642
_UC
Address 130 S. Gilman C.
WILLIAM n,. BFwr7%j J}I
Approved
PLUMBING INSPECTOR ✓
Type of Appliance I Units Fees II
Remarks (Check ✓,
New I Replace I Relocate
Gas Ranges I
I I
Wall Heaters I I
I I I
Gas Plates I
II I
Circulating Heaters I I
I I
Blower Furnaces I / 1 °•.i, oo II
I I
Gas Fired Boilers I I
II 1
Warming (hens
II I
Percolators 1
Griddles I I
II I
Steam Tables
Gravity Furnaces I
II
Suspended Unit
Floor Furnace I
I
I I
II I
Miscellaneous I
u
(NAME, TYPE)
F�u0s 12 I�.�II
I
113 13. -II
1
I I
II I
pp lance Fees /3, 2��
Inspected and Approved ---------- ----- ...............................
DATE INSPECTOR