583 �iC p/Il LOT NO.
NO. STREET
TaIFt,� APPLIANCE PERMIT
c �J61 CUPERTINO 1 Y
Date �^ � Y 196.. . Permit No. S O
.'.t CITY OF CUPERTINO so
Pee $
Application is hereby made to the City of Cupertino for a permit to install =
gas appliances as listed on the reverse side hereof, and agrees to install said
appliances in accordance with the provisions of the Plumbing bode of the City
of Cupertino, and all other laws applicable thereto.
V
Use of Premises
Owner Address
_; wB Address— —
/ ACTOR, AGENT,'
•(D Idll N� & SHEET METAL CO. "`Approved
S AVE., CAMPBELL, CA4Fa'' r PLUMBIN"INSPECTOR
0 v,� � � C1 to n M
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c
4e.
.s
GAMYS, V'ICfj NOT1' OFFICE
COPY
COPY
BUILDING INSPECTOR'S OFFIGvI. .�.,.,._ .._•��
CITY .OF 'CUPERT O
.._:......._..� :1......._... � .
- ..... �+
To �t
• I .
V �.:
You are hereby•authoriied toQne GAS service foi •
`. ;Owner'or Tant ....... ... ......
_ ... .. _ ... ..
At
i. . .7.:,..•;'
New Service :..... � ...............
No. of Meters ........ ............... Reconnect ..................... -
.. Move Service ....................--
No. of Add. Meters -- ---------: ^ M ve Meter-
.
eter4
. i
PLUMBI INSPE
• �t to a%6o-500_,f -�?•` �I .� ` �;, ' _• N