812i Ci I �J LCR Y•Q r G lY �Qa.&OT NO.�
NO. STREET
AP 4�PLIANCE PERMIT
CITY O��[ �PERTINO
APT
aY 1:1;;1962 CC{{ 1�1 rG
Date a _ 196.x.— Permit No.
CI OF CUPERTINO
Fee: S �
Application ishereby made to'the Citytall
of Cupertino for a permit to ins'•,"
(k "' gas appliances as listed on the reverse side hereof, and agrees to;install said
V - appliances in accordance with the provisions of the Plumbing g ode of the City"=•,,, 'I
of;Cupertino, and all other laws applicable thereto.,f< •' -
Use of Premises APARTMENT
u PHILIP RAFALOW„INC. ss
Owner n � Address'.”
/'Lus7L 200 C sti ane
Address
r CONTRACTOR, AGENT
.::; }'s. .`.phnnr ` !i.. J •' Approved - —
,. •s. .. '•. - / PLUStafNC INS GOR
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OFFICE
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COPY
Q GAS SERVICE ":NOTICE
BUILDING INSPECTOR'S OFFICE"
CITY 'OF M-RERTINO
196
To � •
. You are hereby ant i do connect,the A service for
,.Owner or Tenant ................. .--..., .*.
At
i
New Service
No. of --------- -.:._-- - Reconnect --........_..._..........
Move Service' ._
............
of Add. Meters Weter - .._------
--
PLUMBI
NG INSP R
-S00
1107/61