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PERMIT
Date 194--?,' Permit No. -/(063
OF 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 TIP RAFALOW, INC
By 'W MmLi q -
200 CristIC0irs"A TOR, AGIFPP
Phot�mpbell (.alifpr�
Phone 377-5660
7A 7
SC' -
Address
Approved
PLUMB G INSPECTOR
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