1363 �Q.� .3 WC1iM LOT NO.
NO. STREET
y6 3 iLG}A-TI FOR APPLIANCE PERMIT
® C'��
S pl CITY OF CUPERTINO
AUG 5 196
Date AUG 1- 1 63 " 196..... Permit No.--Z/3 b
CITY OF CU?ERT''"' Fee=
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 slid
appliances in accordance with the provisions of the Plumbing lode of the City
of Cupertino, and all other laws applicable thereto.
V
Use of Prcmixs L,64-t-,d��
u f�
Owner /K, Address
By Address
TxncroV R, AGENT
HFjJfA� & SHEET METAL CO, Approved
IBO E. NV AVE.. f,AE1POF:i. 'HLIF, PLUNEING INSPECTOR
Remarks (Check ✓)
Type of Appliance Units Fees I New I Replace Relocate
Gas Ranges I I I
Wall Heaters I IL I I
Gas Plates I 1 11 1 1
Circulating Heaters I 1 . 11 1 1
Blower Furnaces
Gas Fired Boilers I 1 11 1
Warming Ovens I 1 1 I 1
Percolators
Griddles II
'Steam Tables 1 1 11 1
-Gravity Furnaces I 11 1 1
Suspended Unit I II
Floor Furnace 1 1 11 1
Miscellaneous
NAME TYPE)
I Iz-�IIS I
I I z.aE II I
I I II I
Appliance Fees I
Inspected and Approved ..... ............ ......................_..........._..........
DATE. INSPECTOR