NO PERMIT NUMBER E
tu �' / /,% . . ✓ . L.(. .. - LOT NO.
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Ia'. , f `• APPLICATION FOR GAS PERMIT
K CITY OF CUPERTINO
Date 195_ Permit No. /t" '
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Fee $
Application is hereby made to the City of Cupertino for a peimit-to.install gas pipes
and/or gas appliances as listed on.the revgse-sidc heregf, and�,agfees,to.inat ll�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 i -tAMiLY .RLISIDENCE
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�n Owner Address
By JOE AMARALs'PLUMBING, Address
v�A9llti.7e`4to A 1�(�RNIA �
Phone SANTA CLARA,� Approved
PLUMBING INSPECTOR
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hereby aut cdnn�ctthe G rvice or
Owner or Tenant
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New service
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Reconnect
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L It INSPECTOR
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