298 2CN
LOT No. 54
IdlellildGreens
AJ FOR` APPLIANCE PERMIT
'CITY OF CUPERTINO
Date •' _ 196..... Permit No.
Fee S
Application is hereby made to the City of Cupertino for a permit to insta a
d gas appliances as listed on the reverse side hereof, and agrees to install said
\ appliances in accordance with the provisions of the Plumbing r.ode of the City
of Cupertino, and all other laws applicable thereto.
Use of Premises Res
8 Owner Rousseau Ori, _ Addr
SAN C
KS INC- A111161k Addrets
CiSC011779 OLDCCftAtlTY^P.r9&plcervrAPPrPLUMBING INSPFC70Rl
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