2986 tOr NO. Y1152
ra.• Eraeer -- + � Iydlei=ild !Greens
APPLICATION FOR APPLIANCE :PlRMIT
CITY OF CUPERTINO
Date 11/3/60 196..... Permit No. w
Fee SI __
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 bode of the City
of Cupertino, and all other laws applicable thereto.
Use of Premises Res .
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J� Owner RnIIeceau nr$, _ Address�h? *in'Vil _
` San Francisco
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'By-Z, �,: .r- +..v u.-r•.c Iw. Address
s.i ',; cOT?TRAF Ie;JAGENr '' !'1 4
Phone- Approved
PLUMBING INSPECTOe
w� y� 't7l G1 to C1 G1� it
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