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1702! AAPPLICATI'C LOT NO.yLI FOR GAS PERMIT CUPERTINO Date— J 1I Application is hereby made to the City of and/or gas appliances as listed on the reverse and/or appliances in accordance with the pro of Cupertino, and all other laws applicable t Q Use of Premises APARTMENT ti Permit No. U � d7J Fee $ Cupertino for a permit to install gas pipes side hereof, and agrees to install said pipes visions of the Plumbing Code of the City hereto. �,q Owner IP F O I _ _ Address um in By2B06Fis1ieh— Address Campb¢II,`eai ior`o aoa, ncerer Approve Phon _ PLUMBING N f w w U. b � n A R