2371 ,. ...�(.'. 3.l rJ I /� W[Y�Ci �� r ;• LOT NO. 7
NO. -' STREET' - •,Y�
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• APPLICATION FOR GAS PERMIT
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CITY Or CUPPRTINO
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° Date .2U 196
a �Permit No. 7
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i O Application is hereby made to the Cit of Cupertino for permit to install a
1P Y Y P P g'
o W and/or gas appliances as listed on the reverse side hereof, and agrees to install said pipes
is and/or appliances in accordance with the provisions of the Plumbing Code of the City '
a of Cupertino, and all other laws applicable thereto.
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Use of Premises ^e2 ��
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Owner �� �/��< ` �(/, 4r✓ Address
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0 Y C'bNTRACTOR, AGENT
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— < Phone
on�y,,,,State License �C G3r0 Approved
-(Iij PLUMBING INSPECTOR .. -
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i GAS SERVICE NOTICE OFFIC3copy=E
BUILDING INSPECTOR'S"OFFICE
' Ib 888uuu��* v CITY OCUPERTINO
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You are hereby 'author'- d to',connect the GAS sere
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Owner or Tenant ....:.:... ........ _--- ---- ._.. ...........�...........'.. .. -
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At .......... ........:�� ....!.....:- .............
.l':.}� 1 New Service ....._...................
No. of Meters . _.: Reconnect .......... ......_.........
Move Service
No. of Add.,Meters _.. --------- a er ............................
PLUMBI INSPE T R
' tto 6/63-500
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