1507 /3/
Lm No.
No. sneer
®APICA<T gN ,OR APPLIANCE PERMIT
JCriI Y OF CUPERTINO
0E,iP93
0�1 6�3 `
Date 196..... Permit No. �D
C:TY OF CUPERT*'*� Fee S6 .
m Application is hereby made to the City of Cupertino for a permit to install
e gas appliances as listed on the reverse side hereof, and agrees to install said
appliances in accordance with the provisions of the Plumbing bode of the City
of Cupertino, and all other laws applicable thereto.
Use of Premises RESIDENCE
556 N. tar ST.
�n Owner DIR•CRANE _ Address SAN JOSE. CALIF.
By MERCURY SHEET METAL Address 81CE AVE., MT. VIEW
CONTRACTOR, AGENT
C� Phone Approved m
PLUMBING INSPECTO
Remarks (Check ✓)
Type of Appliance Units Fees New Replace Relocate
Gas Ranges
Wall Heaters
Gas Plates
Circulating Heaters
' Blower Furnaces
Gas Fired Boilers ( ��
Warming. Ovens
Percolators
Griddles
Steam Tables
Gravity Furnaces
Suspended Unit
Floor Furnace
Miscellaneous
NAME TYPE) I NNII '
Appliance Fees
Inspected and Approve .... .... .......................
DATE. INSPECTOR