805APPLI .._T1 Fqk APPLIANCE PERMIT
Crr'X [OF GUPERTINO
Date—91 W IJ 1962 Permit No. �S
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r '�( r i IP RT N Fee s /r
p Ap t3tbn 3 here y'ma e to t�e City of Cupertino for a permit to install
Vi gas appliances as listed on the reverse side hereof, and agrees to install said
V appliances in accordance with the provisions of the Plumbing.r.ode of the City
of Cupertino, and all other laws applicable thereto.
Use of Premises APARTMENT`
v 7A7
PHILIP RAFALOW, INC.
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Owner
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B" �• tic f'LH�%tlt[t=�. TAddress_ _Qi tick-L no
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CONTRACTOR, CONTRACTOR, AGENT
Phone_ S 7`•���D Approved— --
i PLUMEING INSPECTOR
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GAS SERVICE NOTICE ..
�� BUI DING ;INSPECTOR'S OSPICE t
CITY m' CUPERTINO
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You are heregauthori.to connect the GAS erd e for, .Owner or TenantAt ._..... - - O:---- ....- -- --
No. of Meters ...... -
No. of Add. Meters ..... ........
New. Service ..._...
-------- ---------
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Reconnect --..-------------- ------
Move Service
PLUMBING INSPECT0.$i
.Ito 7/61-500 - - � � '