683 (2) J.Qo�Z�I yt C K 5 t7 ufLnTNo. A ,
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No. s Idlewild 288C
I� A L A EOR APPLIANCE PERMIT
FEB 7 3962 IfTY OF CUPERTINO
DeN Ujtj* K 196._._ Permit No.
Fee $
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 slid
appliances in accordance with the provisions of the Plumbing rode of the City
of Cupertino, and all other laws applicable thereto.
u
"Ic
Use of Premises�es .
COD Owner Rottsaa n Org- _ Address
SAN CAR
a����✓:METAL W6P.KS. INC. Address an a
Sao
779 OLD CpUtaP 1RVrW, AGENT
/2�er SAS Approve —
PLUMBI
_ Remarks (Check ✓)
Type of Appliance I U—nits� Fees
New Replace I Relocate
Gas Ranges I I II
Wall Heaters
Gas Plates I I�
Circulating Heate�_
Blower Furnaces I II
Gas Fired Boilers I II
Warming Ovens
Percolators
Griddles
Steam Tables II
Gravity Furnaces _i--
Suspended Unit I I II I
Floor Furnace II
Miscellaneous I
(NAME TYPE)
I II
�pp Iance ees
lnspected and Approved 7.o�r`J. _ ...... . . .............................
DATE INSPECTOR
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