2592 LOIN '.._.i5-
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A 90W FOR GAS PERMIT
OC� AT 8 �d ONn
Dae . .... .1`}LL.�T�^It�6:.� Permit No. ..._. =. .�. ......
Fee $
Application is hereby made to the City of Santa Clara for a permit to install gas pipes
i
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 of
NSanta Clara, and all other laws applicable thereto.
a Use of Prcmi:7/- � -'_�
Ownerl!�:c 6' Address
By / Addredo U —
CONTRACTOR, AGENT `
Phone . k_-.fc...- PLUMBING INSPECTOR
3.2-4 REV. ...
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O I G I I I I I I I I I I I I I I Ib A
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GAS, SERVICE NOTICE OFFICI7
BUILDING li1SPECTOR'S OFFICE COPY
CITY OF CUPERTINO
may/
............... 196
To
You are hereby authorized to conned the GAS service or r _
Owner or Tenant _.... ..`.'� -!. .-... -... .....-- .�...�.��_. !.. ......•-....
At
—1 New Service
.( .-.a- .-.-...
No. of Meters .. _.�..... Reconnect ..........--.........--.....
/}f Move Service ---. ..............
_ ...
No. of Add. Meters ... _....... rC M e Meter .._..._...... .........
PLUMBING INSPE R
110 6/63-500 - ���JJJJJJ