1688 �N Pharlap -Ave .' LOT NO.
NO. o T� Tract #3442
® A R. APPLIANCE PERMIT
(WR 10
1964 OF CUPERTINO
Date 3/204.6 �4 fop",1,196._.. Permit No.—/
sY (F'. S
c� Fee S_/ �
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co Application is hereby made to the City of Cupertino for a permit to install
� gas appliances as listed on the reverse side hereof, and agrees to install slid
appliances in accordance with the provisions of the Plumbing rode of the City
of Cupertino, and all other laws applicable thereto.
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Use of Premises Rwg,
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�an@diTffS eilrieg 9y — AddcessSSl n Winchester
f San Jose
San
Car s C-1 Road Address
San Carlos, �r�ll(Q[!-260C oa, wceNr pp
Phone 771 e J A roved
PLUMBING INSPBGTOR•
Remarks (Check ✓)
Type of Appliance Units Fees I New Replace Relocate
Gas Ranges
Wall Heaters I I 1
Gas Plates I I II I
Circulating Heaters 1 I II I I
Glower Furnaces 1 1 1 l.Ogl X I I
Gas Fired Boilers
Warming Ovens I 1
Percolators I I I 1
Griddles 1
Steam Tables 1 l
Gravity Furnaces 1 11 1 1
Suspended Unit
Floor Furnace I I 11 1
• I I II I
Miscellaneous u
(NAME TYPE)
Fee 1 12.001 1
Ton Air ohd 12.001 1
2 Vents I 12.Ogl I _
11 Outlets 1 12.7 1 1
Appliance
inspected and Approved .. ... .....:: ..... : .1?? �...........................
D TF. \ INSPECTOR