1631E r
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LOT NO. --?—
NO: 1 MEET V
9 /;APPLIC'ATIOK FOR APPLIANCE PERMIT
t FEB 2 8 1'15" CITY OF CUPERTINO
FEB 18 lk4
Date 196..._. Permit No.
C*.'". I OF ` , ;K
_ 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 lode of the City
of Cupertino, and all other laws applicable thereto.
Use of PremisesRESIDENCE
Owner INLAND EMPIRE DEV.
By MERCURY SHEET META
Ih
CONTRACTOR, AGBIVr
Phone 139.4223
960 CAMDEN AVE.
Address 6•t'P3F' i CALIF
Address IEW
e
Approve
PLUMBING INSP! O
Type of Appliance I Units Fees
Remarks (Check ✓)
I New Replace Relocate
Gas Ranges I
I
Wall Heaters I
I I
Gas Plates I
I
Circulating Heaters
Blower Furnaces
Gas Fired Boilers
Warming Ovens
Percolators
it I I
Griddles I
II I I
Steam Tables
Gravity Furnaces
Suspended Unit
Floor Furnace
_
I I
II I
" Miscellaneous
o
(NAME TYPE)
OF
Appliance, Fees
-7
Inspected and Approved .. ..)..
'
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INSPECTOR