1659 COT NO. � I
NO. STREET
%-�'APLICATI N FI� APPLIANCE PERMIT
CIfY�6, CUPERTINO
FEB 28 1964 ram,.
Date o2 — oc' 196."11Permit No. v _
CITY OF CARER . '' pee :
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
.-1 appliances in accordance with the provisions of the Plumbing code of the City
of Cupertino, and all other laws applicable thereto.
Use of Premises
W Owner (-c 1 �lLet— Co✓ _ Addr m�► �"
B?,9? ,00(o.+, »3.'�.f..1 Address 81 ALICE AVE. MT. VIEW
ONTRACTOR, AGENT
Phone 739.4223 Approved
PLUMEING INSPeCTOR
Nml
Remarks (Check d)
Type of Appliance Units Fees I New Replace Relocate
Gas Ranges
Wall Heaters
Gas Plates
Circulating Heaters
Blower Furnaces
Gas Fired Boilers �I
Warming Ovens
Percolators
Griddles �I
Steam Tables
Gravity Furnaces 11_
Suspended Unit
Floor Furnace �I
IINOW
Miscellaneous
(NAME. TYPE)
I I II I
layl�yo�ll I
I I II I
_ .ea
Appliance.Fees 1 1573;,,ioJI
Inspected and Approve .
`. .......
F. II CTOR