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772b LOT NO. l NO. STREET AP LM1962 c Date ,9 A(� _..- �NN Ap�l1c'dNonTSR�ereiSy�'�iilaWTIMEity 1 p gas appliances as listed on the reverse side h ln� app:iances in.accordance with the provision of Cupertino,' and all other laws apo [cable Use of Premises ROT�I,§HEET: ETAL, I <hvne 3 CONTRACTOR, AGENT APPLIANCE PERMIT UPERTINO Permit No. 0 0 Fee t�n of Cupertino for a'permit to install ereof, and agrees to install said s of the Plumbing l:odeof. the City' thereto. aL t✓ Approve .,i i �• PLUMBING iNSPECTOR C) to i - OFFICE "' COPY ',bAS SERVICE TICE BUILDING. INSPECTOR OFFICE - -- f - CITY �. OF CUPERTINO Lts . � . ?....."", 196. To You are here y authorize to connect the GAS ' •.: Owner or Tenant _.."""". ..---.._-- - ---- - ---; k :Ai-� - • . _ .a. 1 .�; - New Service- , , No. of Meters ........ M.•.:t;f `"" Remnnect .=r":"t x `---.- ..,..-.t�,. -- --._ Move Service _, - e No. of Add. Meters --- :.:...... '3� .s a, ve eter.. 5--------- =----------- - --- r,fw 'PLUMBING INSPEC O -110 7/61-500