1624 MAL TNO.
NO. STREET -
APPLICATION FOR GAS PERMIT
o I OF CUPERTINO
PS _
DateILDAnn 4 Permit No. ��pp 2-
CFee $,I
At(+1,,, io'� 'e � IKrt of Cu ertino fora permit to install as pipes,.
.and or. a� liantes as"IPste �thtYeverse side hereof, and agrees to install said pip`esi
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\y: and/or.app'iarices in accordance with the provisions of the Plumbing Code of the City
e:Ci
_ ofC6peitino, and all other laws applicable thereto.
a UseofPremises APARTMENT '
% Owner.PHILIP RAW nW1N6 i I Address
By t.r:�7 ���: r 9 Address
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PLUMBING INSPECTOR
;+'?•�.=��• ';' •;' * Phone 377.5660
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