1453 �C LOT NO.
`4 NO. dry` TT ...,.
4AFPCI FOR GAS PERMIT
SEP 2 6 196 ' CUPERTBVO
Date SEP t tgF�tL� .,..1;''1905= Permit No.
_
�� �'VI tKT1N Fee $ • r UG. d,
Ap"pk[tronshereby made tosthe City of Cupertino for a permit to install gas pipes 4.
Viand/or gas appbanceso t
�as?ii§ted he'rev&T' s de;hereof and agrees to instalLsaid'pipes:
and%or;appliances:Zaccordance.with-the.provisionrof-the Plumbing Code of the Cityy,;
, • •�' oPCupertino, and all other laws app(icable.thereto: f'p; :'*•� " '�o� . 7u;:;•;•
Use of Premises
J Owns ----��(�LE y OsNEJ �_ , Address
By 'Y' d.(..f��_ •,:% t' P1�
' �l��l .IvA)E i _ .
- � S Addres
_y`'f CONTRACTOR, AGENT
_1,7 C L I Off l` L� I Approved
i PLUMBING INSPECTOR
'i
� c �
� v z Or
4 i ro � v v � �i .o � ,<. 9 a o 3. Kf n �• .n '_I �^vre
tz
ro
w � ro
---------------------
C � o
' - y
O
N � N
—,I— 2 3
�-�• .r+�,,,�;, / ��cry!