1616 h I SIR, r/!i1\1 �:\ NO. /C 3
STREET
P TION FOR GAS PERMIT
® OF CUPERTINO
Dat PIl 962 195_ Permit No.
/�II Y� [[��. IIP RTIN(� ,cr4
CATp7' P QYRb RjIJ Q Fee $ ,2
ICa on Is e e.City of Cupertino for a permit to install gas pipes
C� 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 APARTMENT
r "' PHILIP RAFALOW, INC.
F, ;7 . 'Owcn7er i Address d.
Address
e ?���CfIStICI1 LC�PIUTRAC F.NT
�l nfl16 ell'TCalrfnrnja .a i 1 .�,�Approved
�" `� °hOOe 3��-S66O + I . EL r1MEINC INSPECTOR'
H G) Z ti G7 m n 0� E0
ww� I'T '9 '?lnwwxlo
1 n m ^J G
O
.n t+1
v n
'v -
o
v
—a
ry _