790_d I Z U _ _:.Y'FLOT NO.
NO. H !tr
alt APPLIANCE PERMIT
A PR 23 1962 C;OF CUPERTINO
A
Dat 6PR 1 0Aq�6..... Permit No. 90
C Fee $ I S -b
Application is hereby made to the City of Cupertino for a permit to install
gas appliances as listed on the reveise side hereof, and agrees to install said
appliances in accordance with the provisions of the Plumbing rode of the City
of Cupertino, and all other laws applicable thereto.
Use of Premises -.a-e-rd --
u
0S Owner /Y -M h4'9 ACJ _
By DIVISION
HEATING & SHEET MVMACTR, AGEN
180 E. SbPHiin!<¢ aVF rAMPRFi i rA11F
Address
Address
Approved �"IISPI�01
_
PLUN8ING
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