1687 W4�ee'LOT NO.ah�Z 'i
NO. TT .i
�® &APPLT FOR GAS' PERMIT
MAY'1 1 196X1 +OF CUPERTINO
APR 2 6 1962
Date "' - 195_ Permit;:No.
CA, us
CU.PERTINO ry '
Application is her made to the City of Cupertino for a pier mt to mstallvgaY P.,7; t�
�. .and/or gas appliances as listed on the reverse side hereof, and.iigrees to install saidTpipes -
and/or appliances ihaccordance with theyprovisions of the�Plumbing Code of the Cit
of.Cupertino, and allFotjh..eyrylawsyyapplicable thereto. �.
Use of Premises
-
k gin. Owner 1 t Address
. 3 ..
' By & SAddress� "' r
1 CONTRACTOR AGPNP T
Phone zf S 7— �i Gi��: �.Approved
• y;:A-"- ' � LUMSING INSPECTOR
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