1338 Tri-plex
� 1
LOT NO.�
NO. STREET V Tract #3055
APPLICATION FOR APPLIANCE PE1EVTcli"e
Estates
CITY OF CUPERTINO
tJU29 ` ^.. 1 !ll
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Date 7/211/63 196..... Permit No.
C.I.: J Y .j. tj'j Fees
N , Application is hereby made to the City of Cupertino for a permit to install
000 gas appliances u 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 Res .
y OwnerDean Inglis Assoc. _ Address 2235 Grant Rd
SAN CARj,OS SHEET METAL WORKS, INC, It a
Address _c
'A(�I CARL /�p�J AGENr
one �PTHuJ J
T
App1p°e PLUMBING INSPECTOR
Remarks (Check ✓)
Type of Appliance Units Fees New Replace I Relocate
Gas Ranges I II I I
Wall Heaters I 1 1
Gas Plates II I
,Circulating Heaters
Blower Furnaces 1 3 1 3.od1 I I
Gas Fired Boilers
Warming Ovens
Percolators it
Griddles II
Steam Tables I
rGravity Furnaces I 1_
puspended Unit I 1 II _
Floor Furnace 11
'Miscellaneous it
NAME TYPE) _
Fee 1 12.4011 1
3 Comb. vents I 11 I
21 Out, -Inlets 15 2511 1 _
1 1 11 I
I I II
Appliance 1h
Inspected and Approved ...............
DA � INSPECTOR