933 /O�7a {✓9 LOT NO.
-� No. STREET •-•
APPLICATION' FOR GAS PERMIT
�a CITY OF CUPERTINO
fs/•�•c��—,' ,195_ Permit
MAR 2 1 /5 a
Fee $
3u�y�ga96pprl ltttt 3' O the City of Cupertino fora permit to install gas pipes
Il! s 1 reld'Ioon 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.
v
.� Use of Premises,_a ��� ��il
n Owner—/��go�!/��P l/ Address _
By JP4;ele—l _� %11� Address v
- / CONTRACTOR, AGENT
Phone C f1 — 3 Olo moo/ I Approved
1 PLUMBING INSPECTOR
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