51145 Gas Permit / O
LOT NO.
O R .
0 'i
I ION FOR GAS PERMIT
44
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,MAR 22 1966 �3Y OF CUPERTINO
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F O
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3U 1 � 96-1Y
6Permit No.
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0 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
zand/or appliances in accordance with the provisions of the Plumbing Code of the City
< w of Cupertino, and all other laws applicable thereto.
Wx
� a Use of Premises
00
3 Own Address
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Jz By Address 6
3
CONTA C[OR, ANT
— 0 Phone —
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0 f State License G3 —2— u a' Approv�d'ILLIAI� ecNEVICH
40 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 Size of Main
Gas Piping Fees
Tested and Approved . .._......___....._ ._,.._................._....................
DATE INSPECTOR