1671 ^ - LOT NO. —
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• NO. TR`8
APPLICATN FOR GAS PERMIT
L I'�MAY 11 190-Y d� CUPERTINO
Date Permit No. Z
Fee $ .
\ Application is hereby made to the City of Cupertino for a permit to install gas pipes
Cy 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.
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Use of Premises APARTMENTp p
Owne PHILIP RAFALOW, INC. I ,I Address �- d cc�two .
w. 6.
By um rn It Address 1
rlSliC'II,,AWNACTOR, AGENT
Phokmpbell, California Approved
Phone 377-5560" UMa1NG INSPECTOR
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