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sTREP�APPLICATION FOR GAS PERMIT
w � 8 1963 CITY) OF CUPCRTINO
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° J Dat e^l4�IS :GPtIInrnT:n"l9tir Permit No.
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� Application is hereby made to the City of Cupertino for a permrc o install gas Pipes
`o < and/or gas appliances as listed on the reverse side hereof, and agrees to install said pipes
'zN and/or appliances in accordance with the provisions of the Plumbing Code of the City
a w of Cupertino, and all other laws applicable thereto.
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Owner
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O CONTRACTOR, GF.�/
3 ua, Phonr�
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i o State License Io���� Approved
U PLUMBING�jrj$pECT pRpp /
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GAS SERVICE NOTICE °OPY
BUILDING INSPECTOR'S OFFICE
1 ' CITY OP CUPERTIN O
.................. .... .'. ....... 196_`!-
To
You are hereby uthorized to conned the GAS.serv'ce for
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� O ,ncr or Tenant�_.t C ��--...,�.. ����...�....
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1L \_ New Service /......,....
No. of Meters ...........!.. Reconnect
Move Service -...................
No. of Add. Meters ..............
/ bvc eter
...........::�.(. .... .... .... /� 1 1f\:'.�{J. .�rt✓.. .
PLUMBING INSPECTOR J
110 6/63-500 \
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