1101 (2) LOT..NO. 47
NO. 3`ia6aT .. - T rbc L
:APPLICATION �FIPR APPLIANCE PERMIT
�QP� 1 1�pj3 CIIKY OF CUPERTINO
Due
1f$/6� . a /I o f
- .196..... Permit No.
. 1 Y 4:;` ID'R7l1'fn zv
q Fee =
M Application-is hereby made,to the City of Cupertino for a permit to install r,
gas appliances as listed on the reverse side hereof, and agrees to install slid
app#ances.in accordance with the provisions of the Plumbing r-.ode of the City
of Cupertino, 'and all other laws applicable thereto.
r4 a. . Use of Premises
Fmino 'el lfoneA Bm 6 f
llligrSHEE1 F.IETAL WORKS, INC A '
ci ''0`;779 OLD COUNTY ROAD —"Y^
o'ti .-477
Address a'
j,V 'R, AGENT
Phone I - Approve
PLUMBING niSP
mil a �
Gglflllr5 ( eCIC ✓�
Type of Appliance I Units Fees ;-New Replace Relocate
Gas Ranges ,.,.
\r/all Heaters JIT
Gas Plates
Circulating Heaters
Blower Furnaces I f.-AII y J
Gas Fired Boilers
Warming Ovens ,
Percolators
Griddles
Steam Tables
Gravity Furnaces F '
rSuspended Unit II
Floor Furnace
Miscellaneous �—
(NAMP TYPO
Fss 12r Dt111
13 out*
Gas 'u 1 II 1 ,/
:
pp lance Fees 1 17� .,,
e
Inspected and Approv '. ..'..... ;s :, .......
UATP. j INSPECTOR. w