1655 0 .
C-/ ✓ LOT NO. e —
APPAT ON FFOR APPLIANCE PERMIT
l
I FEB 2 6 1964 k"ITY OF CUPERTINO
Date . __ FEB 2 1964 r. 196..... Permit No.�
':,;. , Y Ur UUrcn
Fee3 =?G o0
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
ti appliances in accordance with the provisions of the Plumbing rodc of the City
of Cupertino, and all other laws applicable thereto.
aUse of Premises L am.sr t�f
Owned i� c—� �L �d _ Address�39�Amil-,
a l! Address 8I QU AVE, MT. VIEW
GONTaACTOa, AGENT
8 Phone 739.4223 Approved
PLUMBING INSPECTOR
Remarks (Check ✓)
Type of Appliance I Units Fees kNew I Replace I Relocate
Gas Ranges
Wall Heaters
Gas Plates
,Circulating Heaters
'Blower Furnaces I I
Gas Fired Boilers
' Warming Ovens
Percolators it
Griddles
Steam Tables
Gravity Furnaces II
'Suspended Unit _
Floor Furnace I II
Miscellaneous I I —
(NAME TYPE)
I I II I
l.2
Appliance
Inspected and Approved ..............:... ............................................
...
DATE. INSPECTOR