51087 (3) 22194 Mc*Gjellan Road oT No. 2 _
DrIDANO EET
APTTION FOR GAS PERMIT
ITY OF CUPERTINO
0 ► SEP-i41965
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1-7
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Uate �Pnt 1965- Permit No.
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o CITYAI,QF t,"F`Ee�y made TINQ to the City of Cupertino for a permit toms install gas pipes
o and/or gas appliances as listed on the reverse side hereof, and agrees to install said pipes
i N and/or appliances in accordance with the provisions of the Plumbing Code of the City
i w of Cupertino, and all other laws applicable thereto.
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Use of PremisesRQslderiCe
00
Oa OwneFranklin-Bahl Const, AddressP.O.Box 911, Campbell
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By Address!151Queens T•gnP, .G J.
3 _ CONTRACTOR, AGENT
`0 Phone 29 —0556
WILLIAM o. BENEVICN
ao State License 171537 Approved_
U PLUMBING INSPECTOR
Remarks (Check ✓)
Type of Appliance Units Fees IIS 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 Size of Main y/
Gas Piping Fees /.5 0
Tested and Approved . ............................. _.... .................
...............
DATE INSPECTOR