2625 LOT No. 14 - 1
N �n APPLICATION FOR GAS PERMIT
w I, N0V 8 1963 1 :'V( Or CUPERTINO
E 2
0
3a Dateat—0->1 +1i3/nllrlrnTtnt,�l9( Permit No. -
x `o Pees -UO
Application is hereby, made to the City, of Cupertino for a permit to install gas pipes
o and/or gas appliances as listed on the reverse side hereof, and agrees to install said pipes
i m and/or appliances in accordance with the provisions of the Plumbing Code of the City
Q w of Cupertino, and all other laws applicable thereto.
w x
r r
a Use of Premises
o < Owner .�.,7/ 12zelC 41- Z /M,f Address—IL41Y
ZJ
J o ll Addressf
w i Phon �r
w w
Egsi o?a .
0 Stale License Approved E�`S
�—() PIRJ4IB}iQCG1pr•754`fit7FOR �
2ozIlk
� 9
% -- &
a , y
— \ m
-
\ ƒ m
F9
SIT
GAS SERVICE NOTICE OFFICE
COPY
BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTINO
............ ..._...... ..... ... .....
196-.`
To
You arc hereby authorized to connect the the GAS service for
Owner or Tenant ........._A
.. .. . .
...... ...... ..
At .... .........
. . .......... ....... ................
C New Service
No. of Meters ....... Reconnect
..............................
Move Service ........................
- ' '**-
No. of Add. Meters ..,.-,........ M,, Meter _....... . ............
ijo 6/63-5W PLUMBINGSP
IN3 R