784LOT NO 1�7 2N
NO. STREET <1 IS
MY12ft •APPLIANCE PERMIT
:fi CUPERTINO
Date19`21962- .__ ;Permit No. 7o
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a . CITY OF` Pee s/.
.Y. Application is here y.- ,I td tlfd�ity of Cupertino for a permit to install•'
gas appliances as listed on the reverse side hereof, and agrees to install said
appliances in accordance`wittiSthe provisions of the Plumbing rode of the City
of Cupertino,agd 411, otherwlaws applicable thereto.
r. ""++ APARTMENT
y •'Us' of Premises
Oner PHILIP,RAFALOW, INC-
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1 i IUMBING INSPECTOR
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