51087 (2) 10 i e LOT NO.�-
A �C TON^ yr
FOR GAS PERMIT
XtSEP ). 4 19YO CITY OF CUPERTINO
V
a
�S2 3 1965 Permit No✓
OE-CumnPAV1.50
Fee'$
Application is hereby made to the 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
a and/or appliances in accordance with the provisions of the Plumbing Code of the City
wOf Cupertino, and all other laws applicable thereto.
u 2
Use of Premises RaSi clan�a -
00
3 Owner Franklin-Bahl Const. Address 0 Box 911, Camphell
z_
, Z BYstral Service CB lns,$Addres ej� Queens Lane c
J.
3CONTRACTOR, AGENT
�
Phone298 0556
w w WILLIAM D. BENEVICH
M
E State.License 171537 Approved_
G O PLUMBING INSPECTOR
-U L
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 I • Z I Size of Main �31,r"
Gas Piping Fees 1, jcI
Tested and Approved ........................ .......................... .................
..
DATE INSPECTOR