1766"or, LOT NO. /O
NO. STREETTT
J , UIR 1COAi'i�QN FOR GAS PERMIT
JUN 8 1962 WOF CUPERTINO
Date 195_ Permit No.
CITY CF CIUPERTINO Fee $_�
Application is. hereby made to the City of Cupertino for a permit to install gas �es
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 Premises .GC�b"/ ,zf_
Owner--- iI! O
By iU P�w 'An,
. CONTRACTOR,' AGENP
Phone 0 S -�r— Sely O t. i r'A
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