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NO. s"BHT
t .R I A ilFN FOR GAS PERMIT
l� C OF CUPERTINO
JUN 8 1962 ��
Date , 195_;1., Permit No. ` 7�
�( CITY OF CUPERTINO Fee $_��
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.
Use of Premises[ ( '
in
>�o ',�/ Owner .� �+ /���-4,c'.-'' Address....
CONTR TOR, AGBNTT
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* . Y Phone 6 S— -5'r / O Approved
'r, - PLUMBING INSI
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