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14881,4"J LOT NO. sRRRTi i TjNOV 110N BION FOR GAS PERMIT CITY OF CUPERTINO CITY NgFf �BIPjR.TIN©195' Permit No. ( � Eg Date Fee $ T- 00 Application is hereby made to the City of Cupertino for a permit to install gas pipes-, and/or gas appliances as listed on the 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. c Use of Premises— 7 Cn Owner /� ' �GE�1 f'16 ti1E 3 Addred-SO ByW Q[-—oN; Address aO�CONTRA�TOR C�, AGENTFOne L-00. ; AppCOVed PLPRCTO '1 UO1J3dSN1 31yO �% /" pinoiddy puE palsay saad 8mdId�sV9 �/c u:cyQ 30. aZIS / splin0 !o 3agwnN i ONIdId SVO 3SfIOH UO1O3dSN1 31y4 '..._t ............ .....:....... ............ ...-..I..---- ------- panwddy puE papadsul I I II I I (3d)U 3WVN) _ ' i SPCdUEI�aJSI� SES Said s71un I aJPEllddy io