292 f IOM IJ I A LOT NO.�1 v _.
„,-O. - STREET Idletuild Greens
APPLICATIONx FOR APPLIANCE PERMIT
UITY OF CUPERTINO n
Date 11 /3/60 196..... Permit No.
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 code of the City
of Cupertino, and all other laws applicable thereto.
Use of Premises Reg
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V - Rousseau Owner_ Rousseau Orb*, Address 82 Aarket St_
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Sa Address �Fr4cisco
', /w e'•S i ti L.' Co
�VRACTOR^AGENT ^,
Phone - _. . Approved•
'� '� PLUMBING INSPECTOR
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