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APPLICATION °FOR GAS PERMIT
r OF CUPERTINO
9UPERT114V .
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Date ,. 195_ Permit No. �
Fee $,�
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Application is hereby made to the Cit of Cupertino for permit to install as pipes
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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 ofPremisesMiLY rStiutNCE
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Owner aAddress
B)QE AMARAL PLUMBING, Address
32ERT�neT3k^M . r --
Phone SANTA CLAItA, CALIFORNIA Approved �«
PLUMBING INSPECTOR
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GAS SERVICE •NOTICE QFFICE
BUILDING INSPECTOR'S OFFICE -#'OPY
CITY OF CUPERTINO
....................W1.2
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You are hereby auterjzed tczconnect vice for
Owner or Tenant 1 .... .....".-
. ........... .........
. . .....----- ...............
New Service ..........................
No. of Meters ---- ................ Reconnect ..............................
4.
^4- c.; Move Service ........................
No. of Add. Meters .............. Move Meter ..........................
.............. ---------------
UMB NG INSPECTOR
110 1/60-500