931 LOT NO. .
NO. smaa�T�
APPLICATION FOR APPLIANCE PERMIT
CITY OF CUPERTINO
ItSEP 5 1q^9
Date y � , 196..y Permit No. 3 , -
CITY OF CUPERTINO Feel s 00
Application is hereby made to the City of Cupertino for a permit to install
N gas appliances as listed on the reverse side hereof, and agrees to install slid
appliances in accordance with the provisions of the Plumbing rode of the City
of Cupertino, and all other laws applicable thereto.
Use of Premises
u
Owner//;/�' _vim-�'�-L-cJ _ Address
-• By ` Xe Address_
CONTRACTORO , A
Phone �• Y rs<5< Approve
PLUMBING INSPS OR
. �. S m .� •n rn�G1 w�G'1 � .� C7 to n C)� E C1 .
14 M
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OFFICE
Q GAS 'SERVICE NOTICE
` BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTINO
--------:------ !!....... .... ......... f96r
To
You are hereby oriz to co nect the seLvice for
p
Owner or Tenant
O
j
At ---- -
------- _------------
' New Service ---�. '...............
-"-No. of Meters-------- Re
mhnect - t
. Move Service .--...-.
No. of Add. Meters ....... --- Move Meter .... .............
_i PLUMBING INSPECTOR
.110 7/61-500