1104 �'.��`-� I• _ "_ �_� O •• I�� LOT NO.
No. sTRee'r - Tract #3248
APPLICATION-FOR APPLIANCE PERMIT
4 ;� CI y(OF CUPERTINO
JA[I 1�- .u6� �-
Date 119/63 t96__._. Permit No. j
y= GIT f ,r'"E RT'Nf Fee S lO ?� .
c, Application is hereby made to the City of Cupertino for a permit to install
Go
0 gas appliances at listed on the reverse side hereof• ana agrees to install said
appliances in accordance with the provisions of the Plumbing rode of the City
of Cupertino, and all other ws applicable thereto.
Use of Premises_ Rwa
05 Owner Camino Del Homes _ Address' 0 Box 6
SAN CARL 5 SHEET METAL WORKS,tNC. CUD ti
y I +` N ncr a, ncRNr
Address
Approved
Q PLUMBING INSPB R
Remarks (Check ✓)
Type of Appliance I Units Fees II New I Replue Relocate
Gas Ranges
Wall Heaters
Gas Plates
Circulating Heaters
Blower 'Furnaces 1 1. Ol F �+
Gas`Ficed.Boilers
Warming..",Ovens
Percolators I I �
Griddles:..
II �—
Suspend
Floor- urnace: —
Miscellaneous I '
(NAME TYPE _
Fi+eB iz-(](]Ili I
ra4 n + I _ KnNit-
IL I _
I II
pp +ante ees eiat t
Inspected and Approved . ...... ........�X.... .... ... ....................
DATE. uys ECT00.