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NO. SSIy�T�
APPLI
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LOT NO. '
GAS PERMIT
Permit No.—' 73 3
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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
APARTMENT
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.'` Ii Ow ePHILIP RAFALOW, INC. Address )1 /t sc
By�NT!R Address
CristUIF eTOE, nce
='t==• Phone l -Approved
Cam; 9eN, Ea{{}omT�— ! — ' PLUMBING INSPECTOR
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