1361 2037/ .(ti-C.t-!/)L W LOT No. 'z q
No. STREET
APP -I&
I TINNNNII FOR APPLIANCE PERMIT
FfAeuG; 151963 ryr.�CITY OF CUPERTINO
. n�JJ
Date AUG 1 3 1963 196..... Permit No.
CITY OF CUPERP" Fee , 700
Application is hereby made to the City of Cupertino for a permit to install
gas appliances ti listed on the reverse side hereof, and agrees to install said
appliances in accordance with the provisions of the Plumbing r7ode of the City
of Cupertino, and all other laws applicable thereto.
Use of Premises�L t
h Owner /K Address
By Address
HEATING & SHEY9`'11AYM E(9GENr
1811 IPIt8WNY0AKS AVF fAMCAFi[. fAlli Approved
PLUMBING INSPECTOR
Remarks (Chuck ✓)
Type of Appliance Units Fees New Replace Relocate
Gas Ranges
Wall Heaters
Gas Plates
Circulating Heaters I I 11 I I
Blower Furnaces
Gas Fired Boilers I ��
Warming Ovens II I
Percolators jI
Griddles
Steam Tables
';Gravity Furnaces
Suspended Unit
iFloor Furnace
Miscellaneous
NAME TYPE)
/o � zSo
� z.00
Appliance Fees o0
Inspected and Approved ......... _.., .:.... ...............__....__... ........
DATE. INSPECTOR