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V APPLIC N FOR GAS PERMIT
z a itsEP 27 9963 �OF CUPERTINO
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= O Application is hereby made to the City of Cupertino for a permit to Install gas pipes
0 a 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
a of Cupertino, and all o hers applicable thereto.
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= o �y CONTRACTOR,AGENT
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< o /State Licensee L Approved
3 U - PLUMBING INSPECTOR
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