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43611 {� S NO. SMERT 17 LOT NO. �,.� •o^ JJJ LiG'LGc!/% �02 /JJ� 2155 APPLICATIO FOR' GAS PERMIT O MYOF CUPERTINO j), _ 19S Permit No. Fee P)jjYlirffn iCMKRT4fjQthe'City of .Cupertino for a permit to install gas pipes,. `^ an or gas appliances as listed on the reverse side hereof. -and agrees, to install said pipes \) and/or. appliances in accordancewith,the provisions of the Plumbing Code of the City of Cupertino, and all other laws applicable thereto. Use of Premises 05 , 'Owner&oAddress ^By Address' ' I • C N ACT R A T I 'Phone.. ox b`78 Approve 1, J: i 1� Ynny1/8 B� 8 i I i i I ! PLUMBING INSPBCTORt I i 1111111MIN C) to r) Ew O — — — — — — -- — — — — — — — — — — — - — — — — — — — — — — — — — — — — — — — I 1111111MIN