2626 LOT NO.
NO. STH6F.T� I
APP�L-ICA`TIIGN FOR GAS PERMIT
w 1. N0V 8 1963 QLi)JOF CUPERTINO
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o Application is hereby made to the City of Cupertino for a permit to install gas pipes
o a and/or gas appliances as listed on the reverse side hereof, and agrees to install said pipes
i 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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oState License �5� a Approv=41h-e' C
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PLUMBING INSPECTOR
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GAS SERVICE NOTICE OFFICE
BUILDING INSPECTOR'S OFFICE COPY
CITY OF CUPERo
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To 19W
You are hereby, ad.thori4ed to connect the GAS service, for
Owner or Tenant ....
At .......... .....
New Service .....
.. ...... ....
No. of Meters ......... ......... Reconnect ..... ...............
No. of Add. Meters .._.......... fov Service .....................
M e Meter ........ ...........
..
/Z.
..... .............. .... ....
PLUMBING INSPECT R
Ito 6/63-500