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APPLICATIONOR tP L NCE-.'ARM& �
CITY OF C•U TINO
Date 9/23/60 196..._. Permit No.��
Fee S
Application is hereby made to the City of Cupertino for a permit to instal. v-
4 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 rthe City
of Cupertino, and all other laws applicable thereto.
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