1997 a 5"� .�0.I ., � '1 `. •, *.• LOT NO.-
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APPLICATION FOR GAS PERMIT
CITY OF CUPERTINO
Date t -- o 190?' Permit No.
Fee $ 3J
t� Application is hereby made to the City of Cupertino for a permit to install gas pipes
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:
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+ Use of Premises
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In Owne Address �o
By eaJFAddress (t �-
CONTRACTOR;'AGP.NT
Phone0-*-L, T/7J' Approved
PLUMBING INSPECTOR /{
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COPY
y GAS %S , Y, - NOTICE,
BUILDING N WY, -
OFFICE
CITY OF CUPERTINO
To
'You are hereby aut to connect the G ervi _
• Owner or Tenant . . . _
-------_..........
At
New Service '
No. of Meters ...L..-.-.............. Reconnect ...............................
Move Service .........................
C• ..
No. of Add. Metets............... Move Meter ..........................
..-....... .. —
;J;?.? j ' PLU ING INSPECTOR
.110 7/61-500 r .t -1N.{r�`•.;,r`o- . -. _ ._^. _'-