1707NO. STREET
�IYR T O FOR GAS PERMIT
CI OF CUPERTINO
9r�1�sf 11 1962 U.
, 195_ Permit No. ' I G -
Ca CUPERTINO Fee s
Application is hereby made to the City 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.
Use of
PHILIP RAFALOW,.INC.
Owner
By 200 Cr �� Ra n �Nrz r? i
Phone Campbell !' t
alif2rnia
PNc�� 37.5660 �
Address
Address
Approv ZMV
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