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NO. �6TR8ET '
D APPLICAT O , FOR GAS PERMIT
MAY J. 1 1962CI -F CUPERTINO
APR 2 6 1962
Date r.l�r,CpTlpl�_ Permit No.�
4t��UU��LL�I���t �t�l``1I. ,�6
Pee $
Q Application is hereby made to the City of Cupertino for a permit to install gas pipes
yand/or gas appliances as listed on the reverse side hereof, and agrees to install said pipes
and/or appliances in accordancewith the provisions of the Plumbing Code of the City
of Cupertino, and all other laws applicable thereto.
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Use of Premises
4 ' Owner,922 Address
By P - Addresses
CONTRACTOR AGP.NT
Phone L�� 7—. 5��� Approved
PLUMBING INSPECTOR
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