2373 L OTNO.
NO. , STREET 71 -
APPLICATION ,FOR GAWERM1T
^ a c
Z t fJ �9 -6CITY '617--CUPERTINO•
f z n .
l rcLL � r .
o J Date a{.r'r' c—t-.?d• ' 'r+ 196-7 ' Permit No. 73
Pec S_ j,ez)
t N LL
= o
Application is hereby made to the City of Cupertino for n permit to install gas pipes
o� and/or gas appliances as listed on the reverse side hereof, and agrees to install said pipes
iand/or appliances in accordance with the provisions of the Plumbing Code of the City
a of Cupertino, and all other laws applicable thereto.
w
a �
Use'of Premises — L+•-
00
�
"" /I` y» .y
— /iC1u/.�' y Address
0 3 Owner /
,
z 13 rri/�,oc�ix �,Zuiau-`yw„ Address ?
2 O y CONTRACTOR,AGENT" o' L,
— m Phone I
W 6
State License SCG 7<Z7 Approved
a c
PLUMBING INSPECTOR
@m ) oer) C)
) � �
: w m
_ � }
r Ir' I� N N N IJ ✓I � I ti� � Y
m
f T 5. ID
�s o
A
Q
� A
3
I