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.
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Owner IP F O I _ _ Address
um in
By2B06Fis1ieh— Address
Campb¢II,`eai ior`o aoa, ncerer Approve
Phon _
PLUMBING
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