1639 ,VaO JLOT NO. /O
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APPLICATIONS (FOR APPLIANCE PERMIT
F E E 2 � 1964 t.` CITY OF CUPERTINO
FEBf1 ]�g 1964 /3
Dife 1 C f 1 Il_p'.'"' 196..... Permit No.
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Fee =7 isJ
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 code of the.City
of Cupertino, and all other laws applicable thereto.
u
2 RESIDENCE
IUse of Premises
$ 9660 CAMDEN AVE.
Owner INLAND EMPIRE DEV. _ Address CAMPBELL, CALIF. _
By MERCURY SHEET METAL Address Al AffE AVE., MT. VIEW
CONTRACTOR, AGE
Phone 739.4223 Approved
PLU461NG INSPECTOR
Remarks (Check ✓)
Type of Appliance Units Fees I New Replace Relocate
Gas Ranges 1 11 1 1
Wall Heaters I 1 Il 1
Gas Plates 1 Il I 1
Circulating Heaters I 1 Il 1 1
Blower Furnaces
Gas Fired Boilers 1
Warming Ovens 1 11 1 1
Percolators
'Griddles 1 II 1
'Steam Tables
'Gravity Furnaces I l
Suspended Unit
Floor Furnace T
I I II I
Miscellaneous
' (NAME TYPE)
/olasoll I
I I II I
1 o2l X2224 1 _
I 1 11 11 1
Appliance lance Fees 11 1
Inspected and Approved .E�. . . il..............................
INSPECTOR
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