NO PERMIT NUMBER LOT NO.
Na > STREET
APPLICATION FOR ftS PERMIT
CITY`OF. CUPERTIN% ,
r ii
Date A 195_ Permit No. /
Fee $
Application is hereby made to the City of Cupertino fora permit to install as pipes-
and/or gas appliances as listed on the reverse side hereof, and-agrees,to>instatl'said pipes
and/or appliances in accordance with the provisions of the Plumbing Code of'-tti �ity
is of Cupertino, and all other laws applicable thereto.
`'' Use of Premises 1 AMP 1 ✓
ti Owner `•1`•._
_ Address'
JOE AMAR^.'. PLUMS
By : .r^ Address
SANTw:��,.�.�T45,.1'?P Approved@417i1A
Phone
- PLUMBING INSPECTOR
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SERV Cr=, NOTICE OFFICE
`" ..-COPY±�
IL'• ECTOR'S OFFICE sr
OF CUPERTINO
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.....Y. 196./
To
*6 ,,,.,You are hereby authotized•to connect the.GAS,service for
a i '
Owner or Tenant .....a.................... ::...:.::r„/i:!°lt!�`..".�..:!a•''?'«.t..�// ........... ..
C.Ae IL
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No.of Meters ....r.................. Recennect ..............................
Move Service ........................
Na. WAdd:Meters .............. Move Meter ..........................
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W.
._...._........... ............................................
PLUMBING INSPECTOR
Iso 1/60.300