51087 (3) 2 (�� • ' ,a Pl a___ LOT NO.1_
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1SEP 14 1g -ALTION FOR GAS PERMIT
Z2 CITY OF CUPERTINO
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IT)Y e_T�� y"�� � 7
3 196—
Permit No.
W LL Fee$ 1. 50
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� 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
and/or appliances in accordance with the provisions of the Plumbing Code of the City
wof Cupertino, and all other laws applicable thereto.
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W Use of Premises RPSi denCe
03 Owner Franklin-Bahl Const. AddressP•O.Bbx 911, Campbell
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J , B;f_.entral SPrVi ce, Co. Tnc. Addres4t51 Queens Lane, S.J.
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CONTRACTOR, AGENT
— m Phone299-0556 _
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a o ate License Approved WILLIAM D. BENEVIC14
_U PLUMBING INSPECTOR
Remarks (Check ✓)
Type of Appliance Units Fees I 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 . ;L I Size of Main /(C
Gas Piping Fees /,.rtj
Testedand Approved .._.................--- -------------........-------.................
DATE. WSPECTOR