1506 ja38a ..� �� wa.y 30
LOT NO.
��N ST1
�►PnPLICAJT�I [O7��
7NlOR APPLIANCE PERMIT
til / Qti l 9 1963 ICITY OF CUPERTINO
DatS/=+^ NVI01463 ,n,^ 196..... Permit No.
CITY VF CUM I I , s
Fee =Op a
M 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 rode of the City
of Cupertino, and all other laws applicable thereto.
Use of Premises RESIDENCE
p�p1 556 N. IST ST.
17i Owner DIT7.CHANE _ Address GAN JOSE. CALIF. _
By MERCURYSHEETMETAL Address 81 tt AVE., MT. VIEW
Phone ff-TWSOR, AGENT Approve Te
PLUMBING INSPECTOR
Remarks (Check ✓)
Type of Appliance Units Fees I New Replace Relocat
Gas Ranges
Wall Heaters I 1 II 1
Gas Plates I II I
Circulating Heaters
Blower Furnaces 1 .
Gas Fired'Boilers 1 1
Warming Ovens
Percolators 1 �_
Griddles 1
Steam Tables 1 1 1 1
Gravity Furnaces
Suspended Unit
Floor Furnace 11 1
Miscellaneous 1 n
NAME TYPE) 1 1
1 021J—4
I I II I
I I II I
Appliance Fees �—
Inspected and Approved ....._.......:._ ...................................
DATE. INSPECTOR