1272 /-O IR Ar <^ I"V` `�' A- LOT NU. 16
NO. STREET /I -• 1 Tract #2086,•
j APPLICATION FOR APPLIANCE PERMIT
�,,=,�� CITY OF CUPERTINO
Date 6/17/63 .-1196!--.; Permit No. I�
CITY OF CUP `fft�` Fees 6 , 7S-
O Application is hereby made to the City of Cupertino for a permit to install
GO gas appliances as.listed on the reverse side hereof, and agrees to install said
0 appliances in accordance with the provisions of the Plumbing code of the City
,—I of Cupertino, and all other laws applicable thereto.
aUse of Premises Reg .
SANo� er_Cupertino Prop. 'Ltd Address02 Market St. - S. F
CARL RS RC AA`t %K&3, IN'.. I —
ply9 nln cnuNry anno - Address
f� SAN �L g, jar AGENr
.)yv) P o eA1+91U7 Approved-
PLUMBING
D. BENEVICH
, , PLUMBING INSPECTOR
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-GAS' SERVICE TICE '' OFFICE ...
BUILDING INSPECTOR'S"OFFICE
CITY OF CUPERTINO,.---------------------------
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To
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You are hereby a onzed to colinect the GA rvxe or
Owner or Tenant ....-.,,-,!................. 4
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At .... ........l.. .. .........._.. ! ... V.. .. .......................
i .-. New Service .....
No.W Meters Reconnect
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1 Move Service
No. oLAdd. Meters ..............
Te ter .................:........
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PL MBING INSPECT R
Ito G/G3-500