1510 LOT NO.
NO, 0\3TaBBT
H APPLICATION FOR APPLIANCE PERMIT
OCT 9 1963 17Y.OF CUPERTINO
DatqNITsrrE,r3Qu1tf nT-%I!"196----- Permit No.
U1 I-I 1 ll T L-97 �s
Fee S d
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
556 N. IST ST.
Ii Owner DITZ•CRANF _ Address SAN JOSE. CALIF.
By MERCURY SHEET METAL Address 8 ICE AVE. MT. VIEW
Phone 73`9° 422 NMnceNr Approved \
PLUMBING INSPBGTO
Remarks (Check ✓)
Type of Appliance Units Fees II New Replace Relocate
Gas Ranges
Wall Heaters
Gas Plates
Circulating Heaters
Blower Furnaces —
Gas Fired Boilers
Warming Ovens
Percolators
Griddles
' Steam Tables
Gravity Furnaces
SuspendedUnit II _
Floor Furnace
Miscellaneous o
NAME TYPE)
Appliance Fees
Inspected and Approved . ....................
DATE INSPECTOR