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981 .22�Q C. PIT NO. �RRPLI'CATION F19 R APPLIANCE PERMIT OCT 11 �� CTY OF CUPERTINO Date /r/dCdCd���++111LLLv///NNN 196.12, Permit No._Q�__ CITY. OF CUPERTINO Fee $ Application is hereby made to the City of Cupertino for a permit t 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. Use of Premises .6L_h JS Owner I ` ddl Address By < < eo 0. Addres �6 57 edwco,4 LONTRACrOR, A BNr Phone�_��I// 5'o Approved � PLUMBING INSPRO R v �O N f1 A G' y -- ----------------- ---- -- --------- - ---- e � 3 w(�