1400 �L?%L"R TRF-^-- L,l Ail'' IAT NO. /7 .
NO: r��STREET
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_ ,ION•-FOR GAS PERMIT'f' _,.
t OF CUPERTI,NO
SEP 12 1961
Date t95_ Permit"N.w "
CITY: OF CUPER'TINO �j
Fee-$_o2, '<':
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? Application is hereby made to the City of Cupertino_for a, *erm)rto install,kas pipes'
y' and/or gas appliance`s s'listed•on,the reye•ase side hereof,<znd�agfees tot,insstall�`_ Fsaid_pipesi�
and/or p liances"i a Gorda a with the provisions,of'the Plumbing Gode-6 the City
of Cupertino;yandiall:other laws applicable thereto ; s
t)!4a.°S•1,•' Use of Premises,, S//)E
ri Owner Loilfd9�Nwet>-TN�^:,y1Dlt{ _ �Addres o
� j. By i `;, Address
fl CONTRACTOR
aF ,LSI' hone /=/h'-E—G/// v3: I' :" Approved :_:•,:. y
PLUMBING INSPECTOR
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