1572 A�-e-ee LkkSC LOT NO.
NO. I%
D
I N FOR GAS PERMIT
e7�►MAR 22 1962 OF CUPERTINO
i
Date — ,`�19 A Permit No: /s 7 L
G6CITY OF CUPERTINO' Fee $ A,
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 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.
aUse of Premises //
n Owner (PC (_ �Y O Z.S i Address`7's3o
60(L�L�— �oL Addess O'0 N? ONTRACTOR, AGENTone C L / C>�O o I , Approved
I PLUMBING INSPECTOR
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