1688 /V/IO LOT N
; MAY IRF N FOR GAS PERMIT
CITY OF CUPERTINO 6 O r�p ya
DateCM 2ff"WERTINq95_ Permit No. /% _•
+• 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 appliance's in accordance with the provisions of the Plumbing Code of the City
of,Cupertino, and all other laws applicable thereto.
ci'� /� �J 1
Use of Premises�(� TinPi�/
a - 1a9oJn
a,
' � Of
.
nOwner i Address40
Qs
By l Addres
' CONTRACTOR ENT
Phone .S p !Yl
Approve
1�,;,0 PLUMBING INSPECTOR
rt L) z
Z g
A w w w
n.�Oro a n rt
zi
n N w
� z
3
y v �
m :
AR p