1312 .2091/° PLrPPLe TAtr LnNr' LOT NO.
No. f� 5 II -�
�PPCIC N FOR GAS PERMIT'
APR 17
1961 OF CUPERTINO
.Date_ 195_ Permit No.
-CITY OF ,C
Fee $�
i '4, Applicatiori%is bl reby made to the City of Cupertino fora permit to install gas pipes
and/or gas apj liances'`as listed on the reverse side hereof, and agrees to install said pipes
lia❑ces;;iiiEaccordance with the provisions of the Plumbing Code of the City
and/or•app
of Cupertino, ai d all other laws applicable thereto.
°u
a Use of Premises .QCS/D1 NC t
ro� v
` n Owner G Ar w- LAddress
{� B'y P/L" Pl/iinAi v�
�j Address
CONTRACTOR;`AGFNT 'T
ti�Phone C/r-fir— /// APProve 1
PLUMBING ININSPECTSPECTOR
G CT N O w n pOp N w OG "^
V7
n O _
j OFFICE
COPY
. GAS SERVICE NOTICE
BUILDING INSPECTOR'S OFFICE f -
CITY_ OF CUPERTINO. �'� ��•.. ..
��
• + x
To ........................ _... : `.:.._.....;..._., 196'_---
You are herebyu orized to connect the G'i1 S service'
Owner or Tenant
?,
At....... ..
w- -
- New�vicet � •
No. of Meters ......... Reconq'hCls+e4'�r !�" r
.. .......
� Move YServlte.,,_.;
No. of,Add. Meters ........._...
eter
1 Y4 js ` PLUMBING INSPEC OR
110 7/61-500 ;,T �'