891p/, LOT NO.
Y S7vaBHT
A00LINkflWN R APPLIANCE PERMIT
CITY OF CUPERTINO
Y F PUPERTINO
196.-2 Permit No.—
Fee $ 5 ��
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 r.ode of the City
of Cupertino, Bud all other laws applicable thereto.
u
C
Use of Premises
Y Owner_�/)GS �11-140/USO/U _
By ,tLPAY corrtaecroa, nceNrPhone — 1 L1
PLUMBING
A�g Cb rh
Type of Appliance Units Fees I
Remarks (Check J)
New I Replace Relocate
Gas Ranges
—�
%Vsll Heaters
Gas Plates' I II
I I
Circulating Heaters
I
Blower Furnaces
Gas Fired Boilers
Warming Ovens
I
Percolators II
I
Griddles I I
Ih
Steam Tables
Gravity Furnaces
II_
Suspended Unit—II
Floor. Furnace
Miscellaneous
(NAME TYPWi5
Doll
I
I I
II I
I I
II I I
pp lance roes QQI
n I
Inspected and Approved %...yG 6.._ .....................
UATP INSPECTOR