1328I F`S (_=''
PPLICIOI
i U L R 6 1953
FOR
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LOT NO. 169
Idleewwiild
A,PPLIA NCE PLV;41 86
C11''. OF CUPERTINO
Dat e�tw Ty r-$r�9�6�3.r-� r•, 196_._. Permit No._ �3,
co Fee 3�
Co Application is hereby made to the City of Cupertino for a permit to install
''tgas appliances as listed on the reverse side hereof, and agrees to install said
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appliances in accordance with the provisions of the Plumbing rode of the City
of Cupertino, and all other laws applicable thereto.
Use of Premises Res.
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�w Cupertino Prop. Ltd 58 4arket S
SAN tfARL8'ggaelL t7,4 — Addres, �. t'
77$yOLD COUNTY ROAD A
SAN CARLOS, CAtff4MRN R, AGENr
Phone L 1-260 Approve \
�-•' PL ING INSPECTOR
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