1537 /0.3/-7 I 1//C-/r"S'S"IF LOT NO.
NO. STREET
® ri
FOR GAS PERMIT
Cn CUPERTINO
FEB 8 1962 B
Date 19-_-!— _ Permit No. .537
CITY OF CUPERTINO Fee S o?,
Application is hereby made to the City of Cupertino fora permit to install gas pipes
and/or gas appliances as listed on the reverse side hereof, and agrees to install said pipes
and/or appliances in accordance with the provisions of the Plumbing Code of the City
vof Cupertino, and all other laws applicable thereto.
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u /1
Use of Premises Z(-
Owner /(/PE'RT/"6 Pk'nFp,PTius vo. Address GLPLr2Ti.yr
UPD Y LU)" /Al Address G //l al3L L L.
CONTRACTOR, AGENT
N.Y� Approved
Phone
PLUMBING INSPECTOR
Remarks (Check ✓)
Type of Appliance I Units Fees II' New Replace Relocate
Gas'Ranges
Wall Liters
Gas Plates
Circulating Heaters
Blower Furnaces
Gas Fired Boilers
Warming Ovens
Percolators
Griddles
Steam Tables
Gravity Furnaces
Suspended Unit IT
Floor Furnace
Miscellaneous � � i� �
NAME TYPE I I II
�I
' pp lance Fees � � I I
Inspected and Approved ..............:.. i...............................................
DATP. INSPECTOR
HOUSE GAS PIPING
Number of Outlets '� Size of Main 4�
GasPiping Fees � 'oL.,�
—�— —
Tested and Approved ....................
PATE INSPECTOR