1220 No. srRaer 7"
-- APPLICATION','FOR APPLIANCE/ PERMIT
CITY OF CUPERTINO
�iNAY 15 1963 !.= I
Date t96..... Permit No. 1 �Z--->-d
CITY OF CUPER I''' Fees "O
Application is hereby made to the City of Cupertino for a permit to install
gas appliances as listed on the reverse side hereof, and agrees to install said
appliances in accordance with the provisions of the Plumbing rode of the City
Of Cupertino, and all of er laws a liable thereto.
aUse of Premises
ryu r /
Owner _ Address
By — Address
CONTRACTOR, AGRNT
Phone Approv
PLUMBING INSPa
A
o a g
0
---- — --- — --
a �
---------------- --
- 3
—w
9 r�
a — —
TU ————— n
P �
RJ