2091 i o3q F ^� eZJ �d l e� QOT NO. O
NO. STREET
N SAP,,PLICATIO,N FOR GAS PERMIT
p� 1m=�CI OP CUPERTINO
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° ¢ Date { NOU 19 1962 "I' Permit No. sI
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, ° Al I'c3D n� erfiy j ad T`I e Qity of Cupertino for a permit to install gas pipes
0 a and/or ��tpphan es as listed on the reverse side hereof, and agrees to install said pipes
i N and/or appliances in accordance with the provisions of the Plumbing Code of the City
< w of Cupertino, and aI r laws ap -able thereto.
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LL Use of Premises
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0 w" tate License �J 2 5 Approved J'�i
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