1656 ac� k �h f ,�4 LO NQ g er/
NO. STREET �p
JI PP I FOR GAS PERMIT
TY CUPERTINO
1?�IAY 11 19: /
Date APR 6 1969 195_ Permit No. Z6�J
CITY OF CUPERTINO Fee $,2�
Application is hereby made to the City of Cupertino fora 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 iri accordance with the provisions of the Plumbing Code of the City'
'of Cupertino, and all other laws applicable thereto.
v
C I
Use of Premises /h
in Owner �.0 / r� Address .
By �2 Addres
CONTRACTOR, AGI. r I i
Phone(22I Shy , / , Approved
I PLUMBING INSPECTOR
ry C) z
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