51087 (3) 2211 A � T-i-da Vista Place LOT No.�_
® P L� ATION FOR GAS PERMIT
CITY OF CUPERTINO
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f s u 141965
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f� 1965 Permit No. 1. 50
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o Application is hereby made to the City of Cupertino for a permit to install gas pipes
'o i 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
<w of Cupertino, and all other laws applicable thereto,
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� 4 Use of Premises Residence
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a Owner Franklin-Bahl Const. Addresj).O.Box 911, Campbell
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JZ By Gantral Servicp Cn- Tnc.Address451 S,lne .ns Lanp , S.J.
o CONTRACTOA, AGENT
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Phone-2-98-0556
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— �a Approved WLIAM D. DENEVICH
i1PLUMBING INSPECTORU
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 131a- '
Gas Piping Fees
Tested and Approved __....................i.
DATE. INSPECTOR