517 (:>�o DQ . PEPPERTREE LANE LOT No.
. No.._� sraeer
P F~ APPLIANCE PERMIT ,
CI CUPERTINO
L 2 41961
.) Dite P-61 196..... Permit No.
CITY OF GUf'ERTINO Pees 1. 50
0 Application is hereby made to the City of Cupertino for a permit to install
`j gas appliances as listed on the reverse side hereof, and agrees to install said
appliances in accordance with the provisions of the Plumbing bode of the City
of Cupertino, and all other laws applicable thereto.
u
Use of Premises residence
u
in Owner0n!,M.r)e?wFAT TjJ MT T,)ac '. Address
PLO% SHEET &AESAL Address
130 S. Gilman"A6nTMrc-�R8+(eM4
Phone-&—i, °r_i:a._ Approved �_
azi'�' PLUMBING INS PE OR
Remarks (Chale d)
Type of Appliance I Units Fees II New N I Replace I Relocate
Gas Ranges
Wall Heaters I I I I
Gas Phtes I I II l l
Circulalting Heaters I 1 II I •'I
Blower Furnaces I ], I II X I �"'Y 1�
Gas Fired Boilers I I I f,.fl,
Warming.Ovens I I„II�•f
Percolators
Griddles•-'. I , U;N,I`”
Steam Tables
Gravity-Furnaces, I 'I'f.
Suspended Unit
Floor Furnace I j't, . N'�'« 11 I �'
Miscellaneous
NAME TYPE
—.—
I
Inspected and APP roved '
.._..............................
- Y DATP.. INSPECTOR
V
I
Q GAS . SE CE NOTICE . �j OFFICE.
�I BUILDING INECTOR S'OFFICE s .= Cory
-
CITY+ orj
.f7-....................`........, 196......
� TO
You are hereby authorized toyconnect the GAS service for ..
.Owner or Tenant r - . .. . . _. ........
Q . .......0 . . . .. .. ............
At
Service ............
No. of Meters
e
eters :./................. - ,i"P `Reconnect
Move Service .....
No. of Add. Meters .............. Move Meter ..:....................
..- ..:
.... ...........
I ' / . PLUMBING',INSPECTOR
110 1/60-500