559 I - 6
LOT NO.
NO. 5TREm
APPI KATION. FOR GAS PERMIT
OF CUPERTINO
Date LH hog, 10PO93�f_ Permit No.
^/�ll-Is C� F Fee $
�✓
_ WlyatipjERC IKO 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'witg the provisions of the Plumbing Code of the City.,
of Cupertino, and all other laws applicable thereto.
u
. � Use of Premises O, P/J
05 .Owner�f=c�ieA, vQ2�� fnv/t� l.t� '� Address n
BY 1 �� u-�^ � Address 2le_ — ��
CONTRACTOR, A&W, '
.Phone • 4. _(p Approved G t cc
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PLUMBING INSPECTOR 5i
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CA ..,
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GAS SERVICE NOTICEorrlYF
COPY
BUILDING
r
BUILDING INSPECTOR'S OFFICE
CITY OP CUPERTINO
...... ..... ... 4 19
To
You are hereby authorized to connect the GAS service for
Owner or Tenant .:..(/. ... ..... ... .......:.. ....
At .. m
,.:: :.
New Service ✓ . .:
No. of Meters-:.._................. . . . . -Reconnect..'. ..................-...:......
' Move Service ........................No. of Add. Meters .............. . Move Meter .;.....:.......:..........'
P ING INSPECTOR '
110 6/59-5nn '