51181 (2)21441 c.4m Court LOT NO.4
NO. STREET `
FFEB
PI�t~ATION AOR APPLIANCE PERMIT
v OP CUPERTINO
LL 21 1968 1'�,
a Date 196— Permit No.
3U
o r,ITY nT 19PERTIVO Fee -$/Q.,5 --O
Application Is ereby made to the City -of Cupertino for a permit to
o install gas appliances as listed on the reverse side hereof, and agrees to
<N install said appliances in accordance with the provisions of the Plumbing
= Code of the City of Cupertino, and all other laws applicable thereto.
SElie sidence
Use of Premises
OO
'm Owner D1tz—Crane Address
PLUG SHEET METAL CO.
Jz By Address
J'O '50O W&R WGE(R. 0. BOX 9%,
3 P
- a Phone CAMPRFLL, CA) Sia"Jc — 3 7 9 3
Y z
oW.STATE CONTRACTOR'S
i State License Approved
< O LICENSE # 142042 PLUMBING INSPECTOR
_ u�J X
ofApplianceI Units Fees 11 New
Circulatine Heaters I 1 11 1 1
Tables
y Furnaces
Floor I, umace
Miscellaneous
(NAME. TYPE)
4 L
/b
;2,.S-4
P)AN s
y.00
cr
2•[7.0
Appliance Fees