1717 Tract X3442
LOT NO. Jl
NO. STREET Oak DellRanch
A3P &AN FOR APPLIANCE PERMIT
OF CUPERTINO
Dat 2?1AY .....196Permit No.
� (���p CCppTT r Fee S / o
CD CATpYcaGF is�G:DyC R e%' 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
Use of Premises Res.
it Elliot
_
Owner1408 N. Winchester
rn _ n,,,. x. >Qenee�e� Address
San Cams Sheet Metal Works Address San Jose
779 Old County Road CONTRACTOR, AGENT
San Carf cfalifornia 591-2605 11 Approved
PLUMBING INSPECTOR
Remarks (Check ✓)
Type of Appliance Units Fees I New Replace I Relocate
Gas Ranges
Wall Heaters I
Gas Plates
Circulating Heaters I I
,Blower Furnaces • X I
Gas Fired Boilers I I
Warming Ovens
Percolators I �_
Griddles II
Steam Tables
Gravity F nates II_
4Suspended Unit, _
•Floor Furnace
I I I I
'M'iscellaneous I ii I
SMV ME A7PE)fl .
Pee
I I _
I I 1
Appliance Fees I
Inspected and Appro"ved . .. .._...---....._............................
DATF. INSPECTOR