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APPLICAT �` FOR GAS PERMIT
M�Y J 19670 4b CUPERTINO
Date -APR2,6 j VIV�- Permit No.
I i vl� Wil Fee $
Application is hereby made to the 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 with the provisions of the Plumbing Code of the City
of Cupertino, and all other laws applicable thereto.
Use of Premises APARTMENT
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