1536 Jd17.b I !/!G/lf jUI? lr Lor NO.
NO. SMEET
® FOR GAS PERMIT
nM
CUPERTINO
,l/FEB 8 1962
Date /-EBRU,fR Y �. , 19;�•'•- Permit No.
CITY OF CUPERTINO Pee $ oe °O
a
Application is here made to the G of Cupertino fora permit to install s pipes
s� PP � 63' City Pe 1'e Sa p�pe
\ 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
of Cupertino, and all other laws applicable thereto.
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Use of Premises I�E S/Qd'N G t'
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Owner CUALOr/Aro GP aPT/df /r0. Address /UAAnT/A/A
URO Y L rm . iiv<- Address �eOAA,L
CT
CONTRA7 ; OR, AGENT
J Phone - / _ Approved
PLUMBING INSPECTOR
GaT-3
Remarks (Check d)
Type of Appliance I Units Fees II New Replace Relocate
Gas Ranges j j jj j j
Wall Heaters
Gns�Plates
Circulating Heaters � ��
Blower Furnaces
Gas Fired Boilers
Warming Ovens
Percolators
Griddles
Steam Tables
Gravity Furnaces
Suspended Unite—jj
Floor Furnace
Miscellaneous
(NAME TYPE I j jj j
II I II
Appliance Fees
Inspected and Approved ..............:... .............................................
...
DATE. INSPECTOR
HOUSE GAS PIPING _
Number of Outlets a Size of Main 3
Gas Piping Fees �,��
Tested and Approved .... ...... .. ............................
OATS INSPECTOR