1452 LOT NO.
NO.
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p � ee�A FOR GAS PERMIT
SEP
q 6 i1961C F CUPERTINO
F
. Date EP 18•� c 1 ,1�5 ` Permit No.CUFLKIIN ��3/
r ,.CITY Of u
Fee-$
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.r ' ApplicatloR4sihereby made to_the City of�Cupertino fora permit to iristall gas pipe`s" ,*y
• and/orgas applia cn es'as hsted'on the.reveise side hereof, and'agyee's`to install"'said pipe5_,l_"". • -;
.`�' ---a-;and/or.apphances in accordance'with:the provisions of,the Plumbing.Code=of the City •
f a It�irofyCupertino and 'all`other laws,apphcabl��hereto - r "t .i� tS i i< �'���i ' - :`
Use of Premises `�`'�*��'i �'" �� *•-'�'` _._.-.�,._I'
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Owitet�` ' r •l���TA�Iddes�s' � C� '
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i B � ��L"/ E0z — b N C J IAddr
'CONTRACTOR AGENT- '�. "�-
one pC L / • 0 4cl j Approved t)
"' 1 PLUMBING INSPECTOR
ry Z N M G1 y 0 Ge Cl � E O
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