1066 I r L /yT/VW� IiW LOT NO. /3J
NO. STREET,
APPLICATION FOR-'GAS PERMIT
t"EITY OF CUPERTINO
y 1960.,
1 195_ Permit No.
-O
Fee $—/'L--
Application is hereby made 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.
v
Use of Premises
I - FAMILY RESIDENCE
in Owner X!d/ Address-6&6�__,
7one
Address �
6AgTA CLAAA. Cp�tFORNIA Approved
r PLUMBING INSPECTOR
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ELECTRIC UgVICE;NOTICE - me
BUILDING 'R4SPECPOR'S OFFICE COPY
MTINO
CITY OF CU
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To- +�
You am H 2ujunned CPR savior
Owner or Tenant . ... Q............ .. ........... .... .. .. . ................_..._.......
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At. 1_s.?.. ..n .............N.n.S �..a.� ...............-.---...._.
No. of Wires .....I_..._...._ Mae of Wites ..=-Z!"....... Size of Switch . .
MotorLoad..............._._........ Voltage ................................ Plwe........._....._..........
Heating Load ....._............_... K. WW.. Voltage ..............................
No.of Me[m t..Y.—t t0 O New 9eevia.._._. a••••••-•••
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No.of Add.McOets_ int .._.__._320 __ re .
rce ' ;. ._2lore Service._._
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104 1/6o-wo ELECPRICAL