1532 75LOT NO. /�
. NOS s '' ,.
APLICATION FOR GAS PERMIT
'JAN 2 9 1962 W� OF CUPERTINO
Date , 195_ Permit No.
CITY OF CUKERTWO. FeeSaoo
Application is hereby 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
Use of Premises
ro
Owner Address
By—( Address_
nn CONTRACTOR, AGGEENT
PhoneJTo O Approved
1 PLUMBING INSPECTOR
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CCFY
GAS SERVIC�, IjIC al E
BUILDING INSPECTORS FP[CE
CITY OF CUPER INO`
_..�. Yr . Q........ . ............-, 196-.P--
To
You are hereby autthh6rriized to connect the GAS service for
Owner or Tenant ..... � VZ
-- --...- . ......_._ ........
New Service ----
No. of Meters ------/-------------- Reconnect --- -------------------------
Move Service
No. of Add. Meters Move Meter
LUMBING INSPI7CTOR
- IIfY 7/61-500