910LOTp NO./Dqq
NO. sTBBBT
SLIP ATION FOR APPLIANCE PERMIT
® CITY OF CUPERTINO
pit 10 196? , 196.1= Permit No. (1-1
CIT �. G� .: CIJPERTA
s A lication'is Keri
gas app
bance4"^ss aromas listed,
appliancesin.a+co dant
';of Cupertino, and all a
Use of Premises
Oc
By
r14WAIJ
.. _ _ Fee $�� .
pertino' fora permit to install
o ,
aridtagrees t'installlsaid, # . a;.•:
h keh Plumbing bode of th�Cit ^�.,•
Is
Addre�� _
�, Address
Approved'
m _ PLUMBING INSPBCTO
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