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74 50:�"Q) 1/1- LOT NO.
NO. 917JUIET
APPLICATION FOR GAS PERMIT
H, n 2 S /CITY OF CUPERTINO
Date'• r C�" —�" —'� 193_ Permit No.
Fee $ 1 — S C�
Application is hereby made to the City of Cupertino for a permit to install gas pipe's
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 Cupertino, and all other laws applicable thereto.
Use of
Owner1 LASS EAU Address
By L0 1 �i '— J o a e S Address S c STa sc
CONTRACTOR, AGENT
Phone_C 1 O`� Q Approved
�; PL MB G INSPECTOR
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GAS SERVICE NOTICE OFFICE
i�_IyIWYY__-11„ BUILDING INSPECTOR'S OFFICE COPY
CITY OF CUPERTINO�
..... �.:�....... ........ 196,
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You are hereby an o ized to connect the GA e I for
_
Owner or Tenant ......... .. ... �.'... K,n.nw_�t...._--.... - --.. ......
At ............. .�..`1...�......... �...�QJ1.A.��....-- ...
New Service .......✓.-..
i
No. of Meters .......___........ Reconnect
No. of Add. Meters .......
L PL
Ito 6/65.5011
Move Service .......... ............