51087 (2) 107 a Vista Drive LOT NO. 9 _
® SIfic
AATION FOR GAS PERMIT
.zZ. 1SEP 14 1965
I CITY OF CUPERTINO
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KLL
wLL � I i tUC eUPermit No. /—
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Pee'S 1.50
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Application is hereby made to the City of Cupertino for a permit to install gas pipes
o a 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
<w of Cupertino, and all other laws applicable thereto.
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0 o Use of Premises Residence '
> N
Franklin-Bahl Const. P.O.Box 911, Campbell
.0 3 Owr$ngi, 1U Address .
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z s Central Service Co. Inc. Addres)+51 Queens Lane, S.J.
3 o ByCentral
AGENT
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— Phone 299-05,56
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a dWILLIAM 0. F. -
3=NVICH /
°a o 1 State License Approved_ J
U / PLUMBING INSPECTOR
V/J
Remarks (Check ✓)
Type of Appliance Units Fees New Replace Relocate
Gas Ranges
Wall Heaters
Gas Plates
Circulating Heaters
Blower Furnaces
Gas Fired Boilers
Warming Ovens
Percolators
Griddles
Steam Tables
Gravity Furnaces
Suspended Unit
Floor Furnace
Miscellaneous
(NAME TYPE)
HOUSE GAS PIPING
Number of Outlets .-� I Size of Main
Gas Piping Fees ��, Sr'J
Tested and Approved ...._................_ ......-----.........._........................
DATE. INSPECTOR