1402 Z 0��0 P/`PPF'R TSF"F" ,LANG' LOT NO. I/
No.._1 ....-
� N FOR GAS PERMIT
SEP 1 Q 1961 195—
CUPERTINO
Date 195_ Permit No.—
CIT
Y
o.CiTY OF CUPERTINO Fee $
i ry Application is hereby made to the City of Cupertino for a permit to install gas pipes.'
N and/or gas appliances as listed on the reverse side hereof, and agrees to,;instal4said,pipes
• and/or„appliances in accordance with the provisions of the Plumbmg Code,of the'Cit .
t ' Y.
V .of Cupertino;and all other laws applicable'ythereto.
I Use of Premises 'R6.f%D4-N4c ,.. _ "�” 1ia"+
Qv,, Owner-,ej"4rowrA,1rW B/DDS _ Address oS
(Y ,._
By_P/iR_ Dy-.�L/iD7G/AiL co. Address
•CONTRACTOR, AGENT C /
hone F/d` f'-f/// Approv `
+y PLUM0ING INSP4C OR I
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