2021 No
NO. STREET
ON FOR G S PERMIT
OF CUPERTINO
Date f SEP 2102 , 195_ Permit No.
—D
^b�Y Q CUbPERTINO Fee :
to 1 cats is here y made to the City of Cupertino for a permit to install gas pipes
and/or gas,appliances as listed on the reverse side hereof, and agrees to install said pipes
and/or appliances in accordance with the provisions of the Plumbing Code of the City
of Cupertino, and all other laws applicable thereto.
c
aUse of Premises
u
05 OwneAddress
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By�P,P. L "wt& Address
CONTRACTOR, AGP.NT
Phone ?& o�—�1n0� Approved
PLUMBING INSPECTOR
a 5' T x ^ n a ❑ �r coo `� n '� 9
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tz
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onr,CE
cop),
GAS SERVICE NOTICE
BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTINO
...... -- - -l-a ......... - _....... .
To
You are hereby auth rued to connect the GAS -ice for
or
Owner or Tenant ... �* ..- ........
._
At ../_Q� .... _.... 7ce
New S " .. .........
No. of Meters ---1....-.......... Reconnect . ......
Move Service _.......
No. of Add. Meters .... ....... Move Meter ......._ --------- ------
v
PLUMBING INSPECTOR
I10 7/61-500