789 ICIOb� LOT NO. ��OL
NO. S T
A C TIONIZ /iPPLIANCE PERMIT
,f APR 2 3 1 l�CUPERTINO
Date 1 '�' � Permit No. �7
Fee S r
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.
c. {
Use of Premises
Ii Owner �'�" h/iwi _ Address
By—DIVISION Address �
HEATING & Sllt- METAL M"
18CPho1WlNYOANS AVE., CAMPBELL, CALIF. Approved
PLUMBING INSPaCTO
Remarks (Cited. ✓)
Type of Appliance Units Fees I New Replace Relocate
Gas Ranges
\Y/sll Heaters � � ��
Gas Plates
Cir4vlating Hcaters � � �� � f
Plower Furnaces / /So ��
Gas Fired Boilers
Warming Ovens
Percolators
Griddles
Steam Tables
Gravity Furnaces
Suspended Uni[ _
Floor Furnace
Miscellaneous j
NAME TYPE)
PP Lanceeel s /Sy r—
Inspected and Approved .............. ._........_.........._...................---
DATE INSPECTOR