2270 /0 3 �i 9 LOT NO. `� 9
NO. STREET
/ ' APPLICATION FOR GAS PERMIT
z i :•+ 'CITY' OF CUPERTINO
riff 17 r..
y O
3 ¢ Date r'"'rr r •��% L96 3 Permit No. c2a 70
U
i 4 Fee'$
'- O Application is hereby made to the City of Cupertino for a permit to install gas pipes
o a and/or gas appliances as listed on the reverse side hereof, and agrees to install said pipes
iand/or appliances in accordance with the provisions of the Plumbing Code of the City
a w of Cupertino, and all other laws applicable thereto.
' w x
r �
Use of Premises
00
> m
0 3Q OwnerAddress
zJ
o By w IRALIOR, AGENT Address
3 <
— z
vz
ao ' ate License `�� I Approved
_U
&P ' R
c
m �
a y
v -
� z I
O
z
o' 3
—w
N ��n
H :
O _
A -
R''
OFFICE
GAS SERVICE NOTICE COPY
BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTINO
TO ------------------------- ........ 196.
You are hereby autho e to C unect the service for
Owner or Tenant
At ....
New Service ........................
No. of Meters /..........__--- Reconnect
Move Service .........
No. of Add. Meters .............. Move Meter .........
-4 --- I'Lumi
ING INSPECTOR
110 7/61-500