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' NO. � 5 6T , R
® Pfd' CkITrIO�fOR GAS PERMIT
Y 11 impLuc
c.UPERTINo
Date /Y� 19 Permit No.
I.IPERTINO Fee $_-�2-
Application is hereby made to the City of Cupertino for a permit to install gas pipes
and/or gas appliances as listed on the reverse side hereof, and agrees to install said pipes
and/or appliances in accordance with the provisions of the Plumbing Code of the City
\of Cupertino, and all other laws applicable thereto. . -
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Use of Premises APARTMENT
v
�n Owner PHILIP
,�R�AFAn�LO /W, INC. Address
By ��• �Cumbin,Qg� I Address
OO Di$halDfSUCTOR, AGENT
PhonFampbell, California TApprove
Phone 3775660 PLUMBING INSPe a
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