1632E
/-� 9/— f—
LOT NO. `?
NO.STRHRT [/
%,APPP ICAT ON FOR APPLIANCE PERMIT
,)'FEB 2 8 1964 i CITY OF CUPERTINO
Date FEB 18 1.964 _ 196..... Permit No.//�ffJ_
!".f Uf U), -K so
Fee
Application is hereby made to the City of Cupertino for a permit to install
gas appliances as listed on the reverse side hereof, and agrees to install said
appliances in accordance with the provisions of the Plumbing rode of the City
of Cupertino, and all other laws applicable thereto.
Use of Premises RESIDENCE
Owner_ INLAND EMPIRE DEV
By MERCURY SHEET METAL,
CONTRACTOR, AGENT
Phone 739-4223
960 CAMDEN AVE.
Address CAMPBELL, CALIF.
Address 81 ALICE AVE., MT. VIEW
Approved P ti
PLUMBING INSPECTOR
Type of Appliance I Units Fees I
Remarks (Che)
(Check ✓
New I Replace Relocate
Gas Ranges
Wall Heaters
II I
Gas Plates
. Circulating Heaters
Blower Furnaces
Gas Fired Boilers
Warming Ovens
Percolators
II
Griddles
Steam Tables
Gravity Furnaces
Suspended Unit I I
II I
Floor Furnace
11
I I
II I
Miscellaneous I
n I
(NAME TYPE)
11
I/a I rill
I
I I SII
I
I I
_
II I
Appliance Fees
1.01
Inspected and Apprdved�3. . .
DA P. INSPECTOR