1709 Q � 1�� Tract #.3442
LOT NO. 43
NO. STREET 0a k De anC
AP rO FOR APPLIAPICE PERMIT
® .`"�� OF CUPERIINO
5 64 6 r.
D t ', 196..... Permit No. _
Co
N Fee $
0 r TFl9 re n n
ci A ypliSt on atdNto 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
° Res.
aUse of Premises
p�ne Due & Elliot 1408 N. Winchester
Addresssaii
San Car os 6heet MetalWorks
77§10Id CeentV RnAA Allift Address-
C TEACfOa, AGENT '
sap�hCearlos, Califo q �i.9i Approvnee
y/ }I,� PLUMBING INSPECT
Remarks (Check ✓)
Type of Appliance Units Fees New I Replace I Relocate
Gas Ranges I I 1
Wall Heaters I 1 I I
Gas Plates II I
Circulating Heaters I II I I
Blower Furnaces 1 1 1.00 X " I I
Gas Fired Boilers 1 11 I I
'Warming Ovens I II 1 I
.Percolators
' Griddles
Steam Tables I 11 1
C ravity Furnaces I I
Suspended Unit II _
Floor Furnace 1 II 1
Miscellaneous I n
(NAME TYPE) I 11 1
3Ton Air Condl 12•oQ1 1
2 Vents I 12.041 I
14 outlets 1 13 .5111 1 _
Fee 1 12.001
Appliance Fees 01.
Inspected and Approved . .. .......... '.........................
DA F \ INSPECTOR