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51145 (4) LOT NO, NO. TR N FOR GAS PERMIT Wi 1FAR OF CUPERTINO 0 22 1966 3 < Uare 196_ Permit No. �( =LL CITY OF CUPERTINQ Fee S:I- 0 Application Is hereby made to t e City of Cupertino for a permit to install gas pipes 'o < and/or gas appliances as listed on the reverse side hereof, and agrees to install said pipes and/or appliances in accordance with the provisions of the Plumbing Code of the City <w of Cupertino, and all other laws applicable thereto. u 2 ! f J LL Use of Premises O0 3 Owne / Address oa ZJ z By /6 • Address 0 CONTRACTOR, AGENT oo — m Phone vz aState License -z3o� Approved WILLIAM D. RFNrerp-� — 0PLUMBING INSPECTOR Remarks (Check ✓) Type of Appliance Units Fees New Replace Relocate Gas Ranges Wall Heaters Gas Plates Circulating Heaters Blower Furnaces Gas Fired Boilers Warming Ovens Percolators Griddles Steam Tables Gravity Furnaces Suspended Unit _ Floor Furnace Miscellaneous NAME TYPE) HOUSE GAS PIPING Number of Outlets Size of Main Gas Piping Fees Tested and Approved -------------_.....-- --------_....-........ ... ...._._..._.-. DATE INSPECTOR