1628NO. STR88T
Q&TION FOR GAS PERMIT
CUPERTINO
p i�Date rl - 4 Permit No.J
C'���V nnFF (� [[ppT AJ�,� Fee $
V Application 1"s'here� UAld INOity 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.
v
Use of Premises APARTMENT
PHILIP WA LO,W.,'INC. T27
05. 4Owner •• _ Address
" ^-�B7 po' 94c1
y .,�•^d'A°ddress
rw POO-CfIStICI1CJNTRACTOR,AAVW. .- I I ,•. `/
Phurkep�, Sa4'ferii'a oved
I
Phone 377-5660 PLUMBING INSPRCTO•
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