1662V v - LOT NO.
NO. STREET ..
AIZFOR GAS PERMIT
ClCI CIJPERTINO
�Mf!'f 11 1962 115
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Permit No._��0�
C TY Gr- CUPERTINO Pee $�
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
Owner
rr77PHIILIP RAFALOW, INC.
Bytn�� IG, W L:- - Q
200 CrlstlChQrd'�A CTOR, ALRIT T Phor%ID Ph California
Phone 377.5660
7 IQ I
Address
Approved
PLUMBING INSPECTOR
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