51145 (3) r2I o \ ' //' -- LOT NO.�///
NO. S;E
n . P I FOR GAS PERMIT
W z OF.CUPERTINO
i0
W '&�
3 1966 /
o < Date 196cL' Permit No. S-1
3U
�/�, prrp, p1n Fee'.$�/ .�
O Ekj1YatiQFs QI J ERTJQgQ City of Cupertino fora permit to install gas pipes
°o i and/or gas appliances as listed on the reverse side hereof, and agrees to install said pipes
'za and/or appliances in accordance with the provisions of the Plumbing Code of the City
a m of Cupertino, and all other laws applicable thereto.
0 o Use of Premises
'`o Owner/�4//G Address
z CROWN PLUMBING CO.
z By P. (�. Hox 802 Address PLUMBING CO. INC.
o . Box 802
3 < Phon• Saratoga. California
uz y
o f
a
Licensen49 Approve
-PLUDHINC INSPECTOR
vNS
PECTOP
_Up �
Remarks (Check ✓)
Type of Appliance Units Fees New Replace Relocate
Gas Ranges
Wall Heaters
Gas Plates
Circulating Heaters
Blower Furnaces
Gas Fired Boilers
Warming Ovens
Percolators
Griddles
Steam Tables
Gravity Furnaces
Suspended Unit
Floor Furnace
Miscellaneous
(NAME. TYPE)
HOUSE GAS PIPING
Number of OutletsI Size of Main 4 -
Gas Piping Fees I I _
Tested and Approved ..........._. .....__ ....................................
DATE INSPECTOR