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A)APP 49k'TION FOR, APPLIANCE PERMIT
' NOV 2 7 196JI � CUPERTINO
Date NOV 1 6 1962 196 ..... —PaynIt No. �'t
CITY OF CUPERTINO C:�e
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Application is hereby made to the City of Cupertino"—For prmit to install
gas appliances as listed on the reverse side hereof, and agrees to install said
appliances in accordance with the provisions of the Plumbing rode of the City
of Cupertino, and all other laws applicable thereto.
Use of Premises 'tz-a��
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HEAfIyJ a r G� co ra r GP.NT
180 E. SUNtJYOANS AVE., CluvrucC L°�LIP.
Phone
Address
Address
Approved
PLUMBING INSPECT
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GAS SER
BUILDING IN
CITY- O�
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NOTICE
,R'S • OFFICE
OFFICE
COPY,
You are hereby authorize to connect the GASSice for
Owner or Tenant .---1, _/_� ....G�j"'.�M['R"�`-- _....._ _
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At -
% New Service ....4`7 - ...._..
No. of Meters __f ................. Reconnect ............. .
Move Service __..................
No. of Add. Meters .............. Move Metei•
UMBING INSPECTOR
110 7/61-500