51182 10718 Nathanson Ave.
No. Street Lot No.—A
APPLICATION FOR APPLIANCE PERMIT - -
City of Cupertino '
DateMBr Ch 12 , 1969-- Permit No. -
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UApplication is hereby made to the City of Cupertino for a permit to install gas appliancesas
listed on the reverse side hereof, and agrees to install said appliances in accordance with the
o d provisions of the Plumbing Code of the City of Cupertino, and all other laws applicable,
thereto.
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Use of Premises Reg. -
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oOwner Kay Building Co Address P-0. Box 1506
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El oBy .San Carlos Sheat MPtal Address 779 [lira Cn„nttr RA s
y Contractor,Agent ����
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Phone 591-2605
v WILLIAM D. ESNEVIGF!
.State License 110828 .. ` I Appr ved
�. Plumbing:Inspector `y
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