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NO. STREET -
2AZZA L1GA 1 � O:OR GAS PERMIT
CI [Q CUPERTINO
in 8 19( OOJJ
Date_..-! 195_ Permit No.
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CITY " CUPERTIN1O : Pee $
Q 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
'1 n OwnerAddress
ByY'sL�- Address ( •G!
.� CONTRACTOR,-AGENT'
Phone`ES-7-S-6G0,. a P}Approved
PLUMBING INSPE R
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