301 4'Y )114.11.��' �. w LOT NO. #157
No. sTnERT Idlewild Greens
PLICATION SFO'R APPLIANCE PERMIT
L____..i OF CUPERTINO
11/3/EIOntrArr�j/
196...-. Permit No. _
.U� 41\111\
°sr Fee $
Application is hereby made to the City of Cupertino for a permit to install
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 R6iS .
,W Owner_ ROus.se'aiz,,Org. _ AwmA82 rklt St
SAN Ct$jtOS SHEET METAL WORKS, INC. �~' Address an r i sO o
`4h2lof 779 OLD COtW41WACfCA,0AGENr
.arY ! ,jPbbt CAR1.0C. CALIFORNIA Appro
"`^ PLUMBING INSPH
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GAS SERVICE -NOTIC OFFICE
BUILDING INSPECTOR'S OFF). COPY
�• CITY OF CUPERTII'
:..�............................... 196..
To { ^.
You are hereby authori to connect the G mce f ,
Owner or Tenant ..... .�. r ...... ... ( eX��' ,fin(....
Q
New Service .........:....e.-.........
No. of Meters ...../.............. Reconnect .............................
Move Service ........................
No. of Add. Meters .............. Move Meter ..........................
I �
.................
UMBING INSPECTOR
Ito 1/60.300 : .