2149 IAT No. /!
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NO. APPL CATION FOR GAS PERMIT
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CITY f CUPIRTINO
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3 ¢ Date�� 9 1963 Permit No.
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' 0 Application is Hereby made to the City of Cupertino for a permit to install gas pipes
o a and/or gas appliances as listed on the reverse side hereof, and agrees to install said pipes
iand/or appliances in accordance with the provisions of the Plumbing Code of the City
a w of Cupertino, and all other Taws n pt, thereto.
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j n Use of Premises
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Y/ER PIVM6rUC CO Address \ U�t RTI/AO
a Phone
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o State License 0 �� 3 Approved
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OFFICE
COP)'
GAS SERVICE NOTICE
BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTINO
--------
To
You are hereby authorized to tonne the GAS semi o
Owner or Tenant ... nC<%i� _[��! /�W /
At
New Service
No. of Meters .... ..----._..._. Reconnect .. ......--......
Move Service ...._............-....
No. of Add. Meters Move Meter
..
110 7/61-500 .... -
PLUMBING INSPECTOR
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