1713 TLractz111�2
b pd/'Zvr�2 LOT NO. 1LT7
No. k a e arch
�1AtR APPLIANCE PERMIT
VISO
AY 12 1964 ) OP CUPERTINO
Date 5/8/64 196----- Permit No.
N CITY OF CUPERT: 0 Pees ?' 75
co
Application is hereby made to the City of Cupertino for a permit to install
ri 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.
c
a
Use of Premises Res.
Own r Duc & Elliot Address 1408 N. Winchester
San carfos — sante Jo-s�-
779P�Id 6aenty Road Address
$aafonleS, CaIIIOfiti'd'T '> "����')? Approved
/I„ P❑ PLUMBING INSPBCTO
Remarks (Check ✓)
Type of Appliance Units Fees II New Replace Relocate
Gas Ranges
\Y/all Heaters
Gas Plates
Circulating Heaters
-Blower Furnaces
Gas Fired Boilers
Warming Ovens
Percolators
_Griddles
Steam Tables
Gravity Furnaces
uspended Unit
Floor Furnace
Miscellaneous n
NAME TYPE)
OD &iP *U z:.Oi
Vent* a•:
*06 --
I
pp lance Fees
Inspected and Approved .t. (7 :. . .�.. ......................................
DAT I INSPECTOR