574 • �� / �'Li —�n.J LOT NO. d
NO. STREET
1
r*qL T Pf FOR. GAS PERMIT
f CUPERTINO
Date_11-Lilm 1959 _ Permit No. —�
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N 1T�/ .(�[ �p[R f N(� Fee S16>
APRItibn 14 thereg4rlade'tlt�ttk`Aty of Cupertino for a permit to install gas pipes
Vel . 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.
Use of Premises <
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Owner_L�1",IA'.I (�_C Address
I3y .77 ON Address
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CNTRACTOft� AGP.NT
-Phone hA • (fj_I_�SO I,APProved
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