810 i s
I z�211 DA ��,t:�L ay o. ,/
. NO. STREET
AP1 LIANCE PERMIT
CITY O EI
RTINO
IMAY 11 1962 p
Date n-c\-q -� , 196J- Permit No. O J
CIT_ OF CUPERTINO Fee s /•A
o .
Application is hereby made to the City of Cupertino for a permit to,install
gas appliances as listed on the reverse side hereof, and agrees to install said
appliances in accordance with the provisions of the Plumbing r:ode of the City
of Cupertino, and all other laws applicable thereto.
r APARTMENT
Use of Premiiises
C '" t�:`•Owner PHICiP,'RAESW;;INC + _ A`ddiess= C!n�cam.-�
n. � �' 21f �luHt� � 200 ns+,c Lane
�� '"��}v.:,�. CONTRACTOR, AGENT
.'��,'. >-•,t phonr�S�fo � Approved_ _
.i ' � ,' � � LUMB�NSPE •
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