1722 LOT NO. I
NO. STREET
FOR GAS PERMIT
v " I F CUPERTINO
MAY 1y96 I'�
Date Ct-' , 193��� Permit No. / 72,
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CITY 01 CUPERTINO ' Fee $ a
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.
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Use of Premises APARTMENT
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�_(]PHILIP RAFALOW,'INC. Address
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