15977,2- f }A$�_ LOT
NO. NTT ,
V® LI M ION FOR GAS PERMIT
APR 1982 OF CUPERTINO
Date 3 19�?� Permit No. A5 9/
CITY 0 , CUPERTINO Fee a— °=
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 laws applicable thereto.
Use of
,in v
Own
Address
_
BY—
Address
Phone
�� pp CONiAACTOR, AG N
CC.i�
r
Approve
°
PLUMBING INSPECTOR
nzl
_-
I v
o v
�
n
CL
n
�
e
a
H
m
N
n
v
OI
U
i
z'
0
T
. Orace
COP),
()� GAS SERVICE'NOTICE
BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTINO
--------- ........ 196.2.
To
You are hereby autjioriz d to connect the GAS service for
o
Owner or Tenant .. .. _.'._.._... _.. _. .
At-- -- ..---- a--
No. of Meters ... -%.---- ......-.
No. of Add. Meters ..... ........
110 7/61-500
t'
New Service .�_.... _......
Reconnect ....-
Move Service -----
Move Meter _...._..............._.
----- --- -- - -- -----.._---
PLUMBING INSPECTOR