959 ../�(^ �Q�. 4.!lc✓ L4, &S-7 , IAT NO. ".. -
TR - Tract #3156
VOCTPPLICAT N FOR APPLIANCE PERMIT
1 ��� TY OF CUPERTINO
DaV17VW6t I I
Dr- — 196----- Permit No. r r�
G Fee f b
OD Application is hereby made to the City of Cupertino for a permit to install
0 gas appliances as listed on the reverse side hereof, and agrees to install said
rr-1 appliances in accordance with the provisions of the Plumbing rode of the City
of Cupertino, and all other laws applicable thereto.
Use Of Premises Res.
c� Owner?PC 8111 Addressn "i -
sy * Address Cupertino
CONTRACTOR, AGENT �t�i,-^
I` Pl;one �-�6a5— Approved
✓ 1 I 1 1 1 ' PLUMBING INSPECTOR
Remarks (Check
Type of Appliance I Units Fees II New I Replace Relocate
Gas Ranges I II I I
Wall HeatersGas Plates
Plates
'Circulating Heaters
Blower Furnaces
Gas Fired Boilers
Warming Ovens II I
Percolators
Griddles I —
Steam Tables I II I I
'Gravity Furnaces I I
Suspended Unit
Floor Furnace I _
I I I
Miscellaneous I(NAME TYPE)
TYPE)
Inletraa I II
neat if, t-4 !tc I �.Otll
paa I 12.Ogll I
I I II I
PP lance Fees I 111 * fYd
ipspected and Approved .� . .a..�_:.. . . ...............-.............
DAT P, INSPECTOR
OFFICE
GAS"SERVICEi NOTICE Cppy
BUILDING INSPECTOR'S OFFICE
CITY. OF CUPERTINO
To ---- ----- - ------ ----1111.41. ........... 196---
You are hereby aut]3 to connect the Grervr-
Owner or Tenant --- ..
At ... . .....
- ---------- ...... ............
r.
New Service ...........
No. of Meters --.-1.....-._..--- Reconnect ------------------
Mcnle Servi6e.-.:
i>, 4L
No. of Add. Meters -------------- Meter ---------
14��44�1 ........
--7
----------
L ING OR
ktK.l .1 .,1101 7/611-500
OFFICE
.. .. ., r � • 'COPY
GA'S SERVICE NOTICE •
f BUILDINy INSPECTOR'S OFFICE
V
CITY OF CUPERTINO
... ..__./ 1_.... ....-
To
You are hereby aautho connect the G erviceicizOwner or Tenant --- .-.r __......_........
- � �
.....
"•' ' ' ' New Service
No. of Meters .... ..--..._... Reconnect ......-........
v:.
SZ
.h •`t* Move Service .....
No. of Add. Meters............... Move Meter .
.. ' ._ --- ____ ___ ___...._
___F _
PLUMBING INSPECTOR _
,
110 7/61-500