1508 LQ 0.3 _ . . Lor No.
j?q' OMFOR APPLIANCE PERMIT
AeA1CTA�110&-
OCT 9 9963WC11Y OF CUPERTINO
Dam, SEP 30 1963 196..... Permit No.�_
so
Fee =_ �
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 bode of the City
of Cupertino, and all other laws applicable thereto.
Use of Premises RESIDENCE
sse N. IST Sr.
7 Owner DITZ-CRANE _ Address SAN JOSE, CALIF. _
By MERCURY SHEET METAL-1
Address 8 LICE AVE., MT. VIEW
CONTRACTOR, AGBNr
�j Phone 739.477? Approve
PLUMBING INSPBCTO
Remarks (Check ✓)
Type of Appliance Units Fees I New Replace Relocate
Gas Ranges II I
\Y/all Heaters I I
Gas Plates II
Cirnilating Heaters I
Blower Furnaces
Gas Fired Boilers 11
Warming Ovens
Percolators I II
Griddles II
Steam Tables
Gravity Furnaces
'Suspended Unit II _
Floor Furnace
I II
'Miscellaneous
NAME TYPE)
I I II I
I �I o�ll I
i I II I
p0
Appliance ees
Inspected and Approved 1..- ......
DATE INSPECTOR