893 NO. STREET -
�) .
(CATION FOR GAS PERMIT
�•6� �1 CITY OF CUPERTINO
+JAN 20 1960 � -
Date 195_ Permit No.
(CITY Ct , CURERTINO Fee $
Application is hereby made to the City of Cupertino for a permit to install gas pipes
and/or gas appliances as listed on the reverse side hereof, and agyees 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
c a Use of Premises—/ F N�
h Owner_ Address: _
By Address
ONTRACTOR, AGE r WILLIAM D. BENEVICH
Phone Approved
PLUMBING INSPECTOR
m a ti? ^.
v '-•
A � �
ftl
Al
� E z
� 3
R J
TdT
.I n