1710 / (} �/� �� - o iC!/I u fi Tract#3442
LOT NO.
NO. STREET 8 e 8Z1 CY3
P M�,J'1-196
R APPLIANCE PERMIT
® OF CUPERTINO
Dat 1 MAY 191 + ._.. Permit No. 7�_
00 CIT OF. CUFERUNIC; Fees 9��
N App icatlon Is here y made to the City of Cupertino for a permit to install
O 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
N
Use of Premises
Res.
u
`P5Ssn@SF164Shee'. P.1®taN&kst Elliot _ Address1408 N. Winchester
179 Count S Jose
Road Address
San CarjoS, CaliiormaN1�TPR,AW5
Phone Approve
PLUMBING INSPEcTnR
' Remarks (Check ✓)
Type of Appliance Units Fees I New I Replace Relocate
Gas Ranges II
\Y/all Heaters
Gas Plates II
Circulating Haters
Blower Furnaces 1 1 1.0Q X I 1
Gas Fired Boilers 11 1
Warming Ovens 11
Percolators it
_Griddles
Steam Tables
Gravity Furnaces
Suspended Unit II
Floor Furnace 11 1
11 1
Miscellaneous I 1 u 1
(NAME TYPE)
on Air CCqd
Vents I
u , ea
Fee f
Appliance Fees I 1
Inspected and Approve .... ....... :... . ......... ..................
DA INSPECTOR