1678`•� 1 �� �XQ W �sA Y/ LOT NO.
NO. STREET
N6� N FOR GAS PERMIT
Q CGDE CUPERTINO
DatePK 195_ Permit No -1-6 7f -.
CITY Ca CLIPERTINO Pee s_a
Application is hereby made to the City of Cupertino fora 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.
c
v
.i
Use of Premises • APARTMENT '
PHILIP RAFALOW, INC.
-)a
L� /PLM/BING INSPECTOR
z
x
m
c�