1634NO. STREET
® LSAT N FOR GAS PERMIT
CUPERTINO /
P 1962 U' j /*'
Date 5_ Permit No.
•• c o
CITY OF CUPERTINO Pee $
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 appliances in accordance with the provisions of the Plumbing Code of the City
of Cupertino, and all other laws applicable thereto.
Use of
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PHILIP RAFALOW, INC.
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