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1393v y 5 LOT NO. J V f3T0.EET `�" S'a APPLICATION FOR APPLIANCE PERMIT AUG 2 7 1963 CII' ✓OF CUPERTINO 3 J Date— � 196- Permit !'U DUPER -11 NQ Fees 00 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 rode of the City of Cupertino, and all other laws applicable thereto. Use of Owner t� �_ _ By����� NTRACTOR, AGENT Phone��— — � Address/. Address" Approve, 2� PLUM IND INSPECTOR n C 0 N �ryry�=i N