2083 I v`` �G+I-ll) � � �n�OT NO.
1 l• NO. MEET
S,A.,Ps,`PLICATION FOR GAS PERMIT
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/�. `t*. ITY"OP CUPERTINO
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U q � 7 � Permit No. '7����J,
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o A 1'rn 'onpp'sthereby r�gd�[q ghg�ity of Cupertino for a permit to install gas pipes
O < and/or�A��i pli'dtSms asl�i felsnit6�'Iteverse side hereof, and agrees to install said pipes
im and/or appliances in accordance with the provisions of the Plumbing Code of the City
a w of Cupertino, and all 1 r lawZle thereto.
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TEMPORARY GAS SERVICE
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REASON: ..........
nd gas service at the above fixation,
e undersigned agrees to be responsible o the
(intitthe build' d f
iijg is reads, or occupancy, and is released by the Building Department:
City rti o.
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INSPECTOR OWNER
SPE
117 1/6MOO