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1158 cc teW� My'VP LOT No. STREET ���A}}''PP_LICATON%�R APPLIANCE PERAAIT �AR� �o�a GIM OF CUPERTINO Date J C i7 19, 196,3. Permit No. CITY OF CUPERTINO Fee $ G. 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 other laws applicable thereto. aUse of Premises n OwnerUkr i96 c G' ar c Address_ ByAddress CONTRACTOR, AGBNT Phone—��y=f��1 3 Approve _ PLUMBING INSPEU I ❑ 'i1 � � rwi � � � H � o w x N � � 'O v n o i -w m w n O — n