938 LOT NO.
No, STREET
Aff4.1&ATION FOR GAS PERMIT '
® 19
CITY OF CUPERTINO
l 1 195_ Permit No. J
\IS (� T n� (� �F TI[�n Fee $ � t
CI rAYphl3lion5S�ErtbPrA Q the City of Cupertino fora 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.
a,
N
C '
Use of Premises
- v _
in Owner 41/SSBI Address _
By Address 1/1, O c—
CONTRACTOR, AGENT
PhoneApprove t<All /
PLUMBING INSPECTOR t
N z
Z'
' �. O O � � A n C 6. G �_ N O^ W G• G 0=0 N w 0� "
tTj
Nad
l ro
I --- --- ---- E -
ii p _ —w
9 j
O•� y • ---
Tr
L
i 1 � - :.