1461 J / [; GE - LOT NO. O
NO. W TR
D LVT
N 'FOR GAS PERMIT
f�► SEP 2 7 1961OF CUPERTINO:
DatSEP 27 195_ o.
Permit N
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Application is hereby made to the Clty`of Cupertino for a permit_,to msll_gas-plpes��:r,..
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>ij.
s.-of Cupertino,'and all other laws applicable thereto.
Use of Premises' 1 '
Owned /P E 1� d� �S Addre • -��
I - 'CONTRACTOR, AGP.NT. I.
Phone_ /!O•ff O I Approve
PLUMBING INSPECTOR
C) Z
D. Oho O Y. w ., ro U �' =•'Q ,H G W '^ n y a
rt C1 'O n