51087 (3) 22204 McClellan Road LOT No. 1
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TAPP ATION FOR GAS PERMIT
w i CITY OF CUPERTINO
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(SEP 14 1965
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0 , D -7
ate 1965- Permit No. ��0
o CITY 0 COWN Fees 1. 50
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
> and/or appliances in accordance with the provisions of the Plumbing Code of the City
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of Cupertino, and all other laws applicable thereto.
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Use of Premises Residence
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o < OwneFranklin—Bahl Cc)nsT AddresP n .l;nx 91,1' f^am�n�h?11
J Z By Central Service Co. Inc. Addres4t451 Queens Lane, S. J.
CONTRACTOR, AGENT
3 Phone 298-0556
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State License 171537 Approved urn r rnrrt n nrntevrr-H
U i PLUMBING INSPECTOR I
Kemarks (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 2 Size of Main
Gas Piping Fees
Tested and Approved ........._..........._ ..._____.....---.... .....................
DATE INSPECTOR