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1057 Z4/7 ZI 'L C-rte/ LOT NO. ��V
NO.
CHCA ON' t APPLIANCE PERMIT
e�] NOV 2 7 1962c OF CUPERTINO
NOV 1 6 1962 6. Permit 1 c�-�7
© Date CI }Q .... Fee $
1J
Application is hereby made to the City of Cupertino for a permit to 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 �-Q��
v Owner Address _
gv DIVISION Address
HEANNU & 3ritticauTwk
180 E. Nil
one AKS AVE- CAMPBELL, A .. Approved
PLUMBING INSPB
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