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LOT NO. v v
NO.' STREET
APPLICATION FOR GAS PERMIT
CITY OF CUPERTINO
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Date 195_ Permit No.
IJAN 20 1960 57-6..;,
Fee $
ppljcat} is ��ll r Nipq�(� e City of Cupertino for a permit to install gas pipes
and l p2 s a Z-1antei, fis R114e reverse side hereof, -and agrees to install said pipes
and/or appliances in accordance with'the p ovisions of the Plumbing:Code of the City
of Cupertino, and all other laws applicable thereto.
Use of Premises /
Owner_
By -
•CONTRACTOR, A9.NT
Phone
Approved WILLIAM D. BENEVICH
PLUMBING INSPECTOR
IL
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