NO PERMIT NUMBER / {•• -� � _ moi:-'e" ¢ LOT NO.
'i NO. / STREET ,
APPLICATION FO%GAS PERMIT.. .,. -
y CITY OF CUPERTINO. •
+UG y
Date 1960 195_ `Peirhit Nor '✓�n �+ " "' `
Fee
Application is hereby mage to the City of Cupertino for a permit to install gas pipes
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 of Premises f - FAM 1 L Y �t S I U L N C
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ro
�n Owner Address
JOE AMARAL PLU
By E AEA Address
tLWJR?,CML4p+aRNIA Approved
Phone
PLUMBING INSPECTOR
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OFFICE
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You are hereby authorized to connect the GAS rvice foi `
Owner or Tenant .... ..-
or
• ' �"'" _ New Service ._ .............
No.;of Meters .... --------------- Reconnect .......
Move Service ........................
No. of Add. Meters .............. Move Meter ...._------^
r PLUMBING INSPECTOR
110 1/60-500 + 1 �'-