1670 LOT NO.
NO,
i9WI�y
L C{e��- O 6R GAS PERMIT
N I UPERTINO
Date_ca- / 1`60V Permit No.—�
O Fee $ �.
Application is hereby made to the City of Cupertino for a permit to install-gas pipes
p and/or gas appliances as listed on the.rev_erse side hereof, and agrees to install said pipes
o and/or appliances in accordance with the provisions of the Plumbing Code of the City
of Cupertino, and all other laws applicable thereto.
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Use of Premises APARTMENT
a 7a1 _ i
Owner PHILIPR�AFA�LLOW, INC, i Address c "
,By j. &' �//�/.-yI. g Address 41
U CrIGO stiChOk9�p.CTOR, AGA.N -
Pho4ampbell California ! 'I I Approved
Phone 377.5660-- PLu NG INSPECTOR
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