51087 (3) 10'736 L' da Vista Drive LOT NO. 27
A'PP ATION FOR GAS PERMIT
® CITY OF CUPERTINO
f g ISEP 14 .1965
Y
Q LL
J Dare S t 1 1 1965 Permit No.
U CITY OF UuF II Fee $ 1. 50
o Application is hereby made to the City of Cupertino for a permit to install gas pipes
'o a and/or gas appliances as listed on the reverse side hereof, and agrees to install said pipes
r . and/or appliances in accordance with the provisions of the Plumbing Code of the City
z m of Cupertino, and all other laws applicable thereto.
� w
u =
Use of Premises Residence
00
� 3
Owner Franklin-Bahl Const. Addresp•O.Box 911, Campbell
oa
zJ
By OPTItral Service Co. Inc. Addres4+51 Queens Lane , S. J.
J O
3 - CONTRACTOR, AGENT
— m
Phone —
Z
M a WILLIAM D. DENEVIC
0 o State License 1 '7]537 Approved_ tV
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 IJIV
Gas Piping Fees
Tested and Approved ..................... _ __........._...
DATE. INSPECTOR