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21 .55 t�APPLICATION FOR GAS PERMIT
CgY OF CUPERTINO
DateAPRF C 951 Permit No.
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Fee $/
4cat is City of Cupertino for a permit to install gas pipes
and/or gas appliances' lis ed'd reverse side hereof, and agrees to Install said pipes
and/or appliances in accordance with the provisions of the Plumbing Code of the City
of Cupertino, and all other laws applicable thereto. .
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FURNACE
Use of Premises` —
HOMES
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°i IDLE`NILD TR #--Is,:�
in Owner BAN CAR1.1-1c FW!7 -•Addresy.L L.14�B•
,B-- • ,7_79 OLD COUNT _T• Adtl[essCARLOS
By
CONTRACTOR, AGENT
Phone' Approved
I LNG INSPECTOR
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GAS SERVICE N TICE ! OFFICE
BUILDING INSPECTOR OIFFICI ,I'
.CITY OF,CUPERTII�IO','. �1� +' '
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To
-You are hereby.authorized to conned the GAS service for'
Owner or Tenlnt
q I New Service (� ...
No. of Meters .. . ..! Reconnect . ......:...:.
e Service.. Mot, vice....----.::�. .......-,
No. of Add. Meters'..', •Move Meter .........................
P U BING INSPECTOR
110,6/59.500 ,. (/ ,