1707 i /Op/ P , . Tract #3442
LOT,, 1
NO. a De Ranch
TVA& FOR APPLIAPICE PERMIT
MAY 12 1964 OP CUPERr1NO .
Date 196..._. Permit No. 176 /
CITY OF T�1!^ Pees 7% Zs
0
H 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 said
appliances in accordance with the provisions of the Plumbing rode of the City
of Cupertino, and all other laws applicable thereto.
u
u
Use of Premises Res
Due & Elliot 1408 N. Winchester
In Ow of Address
San aros ee e a or S — San Jose —
Sa Carlos Ca lifSrONPACTOa, AyENT
Qi ' 591-2b05 Approved
PLUMBING INSPBCTOa
Remarks (Check. ✓)
Type of Appliance Units Fees I New Replace Relocate
Gas Ranges 1
Wall Heaters II 1
Gas Plates I II I I
Circulating Heaters I I II 1
Blower Furnaces 1 1 1 1.0q X I I
Gas Fired Boilers 1 1 11 1 1
Warming Ovens 1 1 11 1 1
Percolators
Griddles I II
Steam Tables
Gravity Furnaces
_Suspended Unit 1 II
_Floor Furnace
II
Miscellaneous 1 ii 1
-NAME TYPE) I
3 Ton Air Cor1d 12.00 1
? Vents 1 12.00 1
11 Outlets I 12.71 I _
pp lance Fees �—
Inspected and Approved .....-J. r.� .._.. .........._ ....................
DATE. INSPECTOR