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LOT NO. AAA( /j
KAPPLI C ATION )F�bR• APPLIANCE PERMIT
y��`�p�- rt �qp CITY OF CUPERTINO
Date it W�•iJI'3Qjj$QT 196...,. Permit No.
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 slid
appliances in accordance with the provisions of the Plumbing rode of the City
of Cupertino, and all other laws applicable thereto.
Use
RESIDENCE
Owner DITZ - CRANE _
By MERCURY SHEET METAL
CONTRACTOR, AGENT
Phone 739.4223
556 N. IST ST.
Address SAN JOSE, CALIF. _
Address 81 ICE AVE. MT. VIEW
Approve
PLUMBING INSPECTOR
Type of Appliance
Units Fees
Remarks (Chuck ✓)
New Replace I Relocate
Gas Ranges
Wall Heaters
II I
Gas Plates I
II I
Circulating Heaters I
II I I
Blower Furnaces I mil
Gas Fired Boilers I
I
Warming Ovens I
II I
Percolators
II_
Griddles I
II I I
Steam Tables
Gravity Furnaces
I�
suspended Unit
Floor Furnace
_
Miscellaneous I
ii
NAME TYPE) I
I I
/` I/o a.soll
I
II I
Appliance Fees
Inspected and Approved !. �.V.'`F.;.{.C�^..............
DATE. INSPECTOR