925 /L' •l , I ��If' l.�U.iiC�rJ' i��i� LOT NO. /f
NO. STREET
APPL�IIC TION' FOR APPLIANCE PERMIT
CITY CUPERTINO_,
.f AUG 3 0 9992 U � ^� .�
(� Date 196.:... Permit No. _
4� S�CITY OF CUPERTII�C� Fee s
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
a appliances in accordance with the provisions,of the Plumbing rode of the City
\D of Cupertino, and all other laws applica 4herettoo..
Use of Pr
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niCONTRACTOR nceNr
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$• s .. PLUMBING INSPECTOR
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