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1753 T/r < - _• LOT NO. NO. STREET ® ipm N FOR GAS PERMIT OF CUPERTINO AY 17 1962 Date1�,�M /' 194 Permit No. -5-3 a . CITY OF CUPERTINO Fee $ "g Application is hereby made to the City of Cupertino for a permit to install gal 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 I of Cupertino, and all other laws applicable thereto. v a Use of Premises 'A�"f/Otwe p' U.) Owner Z-&2&9d% edAlIr Doe.ri:aly Address �Ail1D,9dLG By Pii.C'DI' .�i�li/iIB�Nf -' Address CONTRACTOR, AGENT I - Phone Approved PLUMBING INSPECTOR gL) z . w n o v v. n n I rt w N O t - ------------------- .� c Q z ---- Al z E � 9 m H : r—r- -————————— —— �n _ Ing