488 LOT NO.
NO. STREET
2.2 48 LI FOR GAS PERIt91T
UPERTINO
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Date �J 1 Permit No.
CITY OF CUPERTINO Pee $
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.
aUse of PremisesJ�=�lf�
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Owner -��<� AddresSl � �1��
W. L. Mt rLY SO&IS, 1N '
By----.--P_-.0,. i Address
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iPhone ,�, ! ,ppi, 1 1 PLUMBING INSPECTOR �v
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GAS SERVICE NOTICE Orr•ICH
i COPY
BUILDING INSPECTOR;p •FFICC i
• CITY OF CUPERTIMO 4.1 ?i
.............. � u- `a.C?..
To
You are hereby auth
o
rized to connect
the service For
Owner or Tenant--- ...I/. .._.
..... ... . .... . . .
.........
. .
..
New Service : -.
No. of Meters ......... ......... . - Reconnect...........::...........
Move Service 1 ................ -
No. of Add. Meters .:............ `Move Meter i...:.
............ "d
.....--- -.. .. . ................---........_......... ........
PLUMBING' INSPECTOR
tin 69-500
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