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.
ip�VR APPLIANCE PERMIT
� OF CUPERTINO
FEB 7 " 6 U i' //_�, �
Date 1 262 196..... Permit No.�_
CITY OF CUPERTINO Fee S / 'T
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
yy of Cupertino, and all other laws applicable thereto.
2
Use of Premises Res.
17 s Rousseau Org, 582 Market St.
Owner _ Address
SAN CARSHEET METAL WORKS, INC. Ad&k Address n r cisco
779 OLD COU9lTX4W=-, AGENT n
z� SAitl:Qdk131S �C6LIEORNIA Approv !
Remarks (CheckJ)
Type of Appliance Units Fees I1 New I Replace Relocate
Gas Ranges I T-11
Wall He.uers �)
Gas Plates
Circulating Heaters �__
Bloa%er Furnaces 1 X
Gas Fired Boilers 11
Warming Ovens TI
Percolators. a
Griddles II
Steam Tables
I
Gravity Furnaces ll
Suspended-Unit
Floor Furnace
Miscellaneous
(NAME'TYPE)
pp lance ees 1� _
Inspected and Approved .. .•... . .......•.
DA 1 SPECTOR