1711Nom-�
NO. MEET
rV)4,PL'kATlQNrFOR GAS PERMIT
CITY O CUPERTINO
11r!'f 11 1962
Zell/
Date 19 �� Permit No.
o
CITY O'CUPERTINO Fee $�=
Application is hereby made to the City of Cupertino for a permit to install gas pipes
and/or gas appliances as listed on the reverse side hereof• and agrees to install said pipes
\ and/or appliances in accordance with the provisions of the Plumbing Code of the City
of Cupertino, and all other laws applicable thereto.
v
Use of Premises'
APARTMENT
7a7 r '
�n Owner PHILIP RAFALOW, INC. Address
.w.�PBy ur„ Address
fl$tlCildnBl�ty1CT0E, AG�T � I 7
Pho hone ell, California Approved
Phone 377.5660 —� Pi MB NZISPECA
2
'� �• i� OFFICF
q GAS SERVICE NOTICE " coPY.
BUILDINGINSPECTOR'S OFFICE
/ CITY OF _CUPERTINO `
.....---.........---J.-_'"..-_`.-L.."�.:...........
To
You are hereby aut e tp c cc the GA rvice f
Owner or Tenant
At.....................
-
New Service :.-.-.--.-
No. of Meters .--- o✓-..-.._.._-: Reconnect
Move Service
y
o. of -. .---..... v er
V . . _Meter's f :h
PLUMBING INSPECTOR
110 7/61-500