51087 (4) 10716 Linda Vista Drive LAT NO.229
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® N n
UAL I ATION FOR GAS PERMIT
h < ,CITY OF CUPERTINO
x o s E P 14 1965 _
3 '< Date Sept. 13 1965 Permit No. d
.0 CITY OF CUPERTINO Fer$ 1. 50
O Application is hereby made to the City of Cupertino for a permit to install gas pipes
oa and/or gas appliances as listed on the reverse side hereof, and agrees to install said pipes
i m 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 I
a Use of PremisesRPgi (9PnCP
20
> 3 OwneFranklin-Bahl Const. Addresp•O.Box 911, Campbell
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z By Central Service Go_ Tnc. Addres51 Queens L•an ., S J.
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CONTRACTOR, AGENT
—
Phone —
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a 171537 WILLIAM D. BENEVICH
°a o State License Approved_
U PLUMBING 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 d
Testedand Approved ...s......____......i......_...-._......_..._...__............
DATE INSPECTOR