1362 LOT NO. 2S
No. STREET
;s
VA
AWCLA I N� FOR APPLIANCE PERMIT
CITY OF CUPERTINO
UG 15 1963 '
Date AUG 1 3 1963 196..... Permit No. /
CITY OF CIIPERT'° Fees C)
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 code of the City
of Cupertino, and all other laws applicable thereto.
Use of Premises wCa- ,i—.mss
u
W) Owner Address_
By Address
UIVI ACTOR, AGENT
Q F' &G & SHEET METAL CO. Approved
J
180 E. SUNNYOANS AVE., CAMPBELL, CALIF PLUMBING INSPECTOR
Remarks (Check ✓)
Type of Appliance Units Fees I New Replace Relocate
Gas Ranges
Wall Heaters
Gas Plates
Circulating Heaters
Blower Furnaces / �'i.Su ✓
Gas Fired Boilers
Warming Ovens
Percolators I I�
Griddles
Steam Tables
Gravity.Furnaces
iSuspended Unit II _
:Floor Furnace
'Miscellaneous
(NAME. TYPE)
pp lance Fees 7.0�
Inspected and Approved ..............i .......................
DATE. INSPECTOR