451 LOT NO. .�
APPLICATION FOR GAS PERMIT
;'Y CITY OF CUPERTINO
Date ✓�Ifin,? Permit No.
t�t��Y r� qo[p Fee $
30.
t 5Yhb 6' IdNMt' ' "i'� Appl re y m th 1 of Cupertino fora permit to install gas-pipes .
! '.�4`and%6rgas iippllances'as listed�oirthe reverse side.hereof;,and'agrees to:install,said 1pipes.,,,
and or aggpp lgr�esl��gQr.. aQ .t � .. 11t�6n'provisions of the-PlumbingCode.of the,Cit
of Cupert}tf�,land �Eltotli�f`l�lvl eab9� hereto.eY y,
s Use of Premises/ /
I 17, : Owner -t' /fddress
By r.. L. Ri1.ar aL r.d, IP:C. Address _
i •. *..� P.coTaT'eacroif;n�Nr " . i
c., Phone Sunnvvnh. C„nr Approved'
PLUMBING 114SPECTO a
� 4� ,2 N � "'�Gj ,� � G7mn4�$ ��
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