462 20984 I Pepper Tree ,Lane 12
LOT NO.
NO. STR8
14&'
AR APPLIANCE PERMIT
l PR 19 1961 ; OF CUPERTINO
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Date—.4'�18�61 196..... Permit No.
:.CITOF CUPERTINO 5�
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App��catioy;yis'hertebymaa_ deto themeCity sf,Yupertino for a permit to instal!
1 gas ap`phancFS agih'#edtor�nthekever e•S, a hereof,.and agrees to instill said
r-I appliances m accordance with the ns of the Plumbing bode of the City
.�.. : of'Cupertino, and all other laws applicable thereto.
Residence
ofPremises
rF y David at Winchester
.in�:r Owner_-'C nmtppn,.,A_��ei+tirin"'�� Address
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San _,Jose
J By; '-;Eog�-Sheets Metal Address a_ .,
.: CONTlACT00., AGBNT
pt:one --Tr 8-0 314. APProved )
�'i -PLUMBING INSPBC O
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