1706GAS PERMIT
y�I Date CITY U- 1`IW Permit No. /7 e
E Fee $
Application is hereby made to the City of Cupertino fora 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 APARTMF t
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ne PHILIP RAFALOW, INC. i 1 Address �- tm
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By l.(I$ ICACT00., AGENT
Pho Cam, bell, California I I Approved
5560 E....ING INSPECT �Y
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