115 Z o a g I Lor No. 7 7
NO. T
N"F fit, APPLIANCE PERMIT
TMAR 251966 Y CUPERTINO
Date MAR 2 2 1960 196..... Permit No. //
CITY OF CUPERTINO �so
Fee s_
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 Code of the,City!r
of Cupertino, and all other laws applicable thereto. `' -
Use of Premises 1t4_1V_ ""
17i Owner ����UIQ ,t AddresU1,41s
,: ....z:
ByG ddress
- 180 EjSUNN40RR91ML'CnRCI0�aMEL, C '
' Phone
PLUMBING INSPECTOR
a s
Remarks (Check d)
Type of Appliance I Units Fees II New, I Replace I Relocate
Gas Ranges II
Wall Heaters
Gas Plat 44� '' I
Circulating Heaters —I
Blower Furnaces
Gas Fired Boilers I 11
Warming Ovens II
Percolat6rs
Griddles I II I
Steam Tables I I II
Gravity Furnaces I I 11 I I
SuspendedUnit p
Floor Furnace I I
Miscellaneous I I n t
NAME TYPE)
I I ' II I
I I � II I
I I II I
I I it I
Appliance Fees ((--
Inspected and Approved _ .. _ ;.... " --
_.y y . '•.,2. INSPECTOR ', ..
.D TF.a.=,� .
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p ."✓
f / GAS �ERVIE f��OTICE Z%pYF
BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTINO n
............._.----_. ---5149. -...........................
To
You are hereby auth 'zed to connect the GAS se for
Owner or Tenant -1`� �!.. ke
At- .. C7..[.�.." . .- iii-- . ... L�f..:.. ...............................
y 3.
x
a New Service .............. ...:....:`.
No.of'Meters .... ---....' �` `;"' Reconnect ..:"k:,
` Move Service ........................
No. of Add.,Meters by- et tom........... ..
Mby- ,M eter< :... s-e_.
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Z. } PL+�ULM'BINIGI� INSPEC(�-OR f
✓ ttn.6/,59-5oo ��ei_V `� >1a•� `�y„i 5,, .Q,�
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