2799-GAS LOT NO. / 9
® P I pA IOid FOR GAS PERMIT
W Z '� 'APR 27 1964 CITY OF CUPERTINO
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3 a Dat a 1962 Permit No.
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0 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
'z - and/or appliances in accordance with the provisions of the Plumbing Code of the City
a W of Cupertino, and all other laws applicable thereto.
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Use of Premises -
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3 Owner ' Address
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J - / Address��
O j CONTRA OR,AGENT /
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— 0 Phone 0296 -396 3
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a o State Licensees TS29g I Approved
U I PLUMBING INSPECTOR
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Remarks (Check d)
Type of Appliance Units Fees I New Replace Relocate
Gas Ranges
Wall Heaters
Gas Plates
Circulating Heaters
Blower Furnaces
Gas Fired Boilers
Warming Ovens
Percolators
Griddles
Stem Tables
Gravity Furnaces
Suspended Unif
Floor Furnace
Miscellarieous
NAME TYPE)
HOUSE GAS PIPING
Number of Outlets Size of ain —
Gas Piping Fees ,
. .z7. ..`�i.. .--..._..................
Tested and Approved .
DATE INSPECTOR
OFFICE
GAS SERVICE NOTICE
BUILDING INSPECTOR'S OFFICE COPY
CITY OF CUPERTINO
........... ..
........ ......
........ ........... 1964
To
You are hereby aut orized to connect he GAS service or
Owner or Tenant ................. .......... .... .. ... ...
A 'Z '� - T. ....................................................
At .. .......... -.. I
.... .......... ....... ....
+- -r-QQ------lA.. ----
---------( New Service .......
No. of Meters
............. Reconnect ..............................
Move Service ........................
No. of Add. Meters .....-------- Moe Meter ..........................
V
t PLUMBING INSPECTOR
i to 6/63-500 )
BIdg. Dept
Office Copy
BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTINO
❑ Sewer Connection Sanitary Permit No. .... ... ... .............
2--Plumbing Final Plumbing Permit No. Z.7-99..........
Lot . ........
Owner or Tenant ......
C ....
-Q ..
. . ........... . ... ....-'--- ---
Cz- -----
.... ..........
At ----------
Tract ----------------------------
Date Connected ..........................
.I - --1----- . .... .. ............... 19`--(
DateFinal .............................................. .. ...... .... ......... . ------------------ 19 ....
------- --------- .. .... ... ......... -------
PLUMBING I SP 0
1ll 7/63-1M