1602 LOT NO.
NO.
G
OR APPLIANCE PERMIT
,!JAN 22 1964 OF CUPPWMO
Date /r '1 196..."/ Permit No.
h CITY OF CUPERTINO For a d
YAppli Ation is hereby made to the City of Cupertino for a permit to install
y gas appliances n listed on the reverse side hereof, and,agree to install slid
V appliances in accordance with the provisions of the Plumbing .ode of the City
\ of Cupertino, and am of ther.laws applicable thereto.
Use of Premises l iC —c�r�.u��
6
Address�u U0
'* Addrrs+&a-44—eyC—hitl�uu�
ONTRACTOR, AGENT
Phone 3 P— `/_ Approved
PLUMBING DUPECTOa
Remarks (Check J)
Type of Appliance Units Fees New I Replace I Reloca
Gas Ranges I II I I
_Wall Heaters I I II I I
Gu Plates-
Circulating
lates Circulating Heaters I II I
Blower Furnaces
Gas Fired Boilers I II I I
' Warming Ovens I I II I I
Percolators I I I I
Griddles
Steam Tables
Gravity Furnaces I I II I
Suspended Unit I I II I
Floor Furnace
Miscellaneous I I iI I
(NAME. TYPE) I I II I
I I II I
l Yla�-°II I
I I II I
Appliance Fees
Inspected and.kppro'ved ..t� Z�: v
.---- -------.....................
DAT INSPECTOR