1719 N0 GAS PERMIT
+�1 MAY 11 jgy' UPERTINO
Date eL19 �' Permit No'--
CITY PERTINO
Fee $
`0 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 N 3"
`}'"•�L OwnerPHILIP RAFALOW, INC. I Address
By w.aa....,�m� .,M�: Address. .
ZOO Crls}IChCLgWACTOR, A .NT-. I _
Y Phoma be I I I Approved
Phone 3775660 " i,.. =I' EUMBING INSPECTOR
�. � G• A yyKm � C a 'Tl P � 0 UG 6. C� N w_ on '^
z —__—_ G
> c
E �
� n 4