1428 �O�J IO J3 LOT NO.
NO. '� BTREE7�
^® ITI FOR GAS PERMIT
66T CUPERTINO
,,__ SEP `q g 1961
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N 1,
aDate .I _ Permit No. '
OF'✓CUPERTIN Fee $
1
App lication�js hereby madeto the ity of Cupertino for,a permit to install gasp Ts
4 I and/or app"I listed on the reverse side hereof, and agrees to install said pipes
9 and/or.a"ppliarices,in,accordance with the provisions of the Plumbing Code of the City
'1 'j of Cupertino;'�andiall other laws applicable thereto.
. � Use of Premises•,
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0
Owner �r,+�..e�O,/_/ `.Q,o.✓awaAddre
O
By Addre
CONTq ACT00.� AGP.N
Appro.
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