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1267 i 9 y80 72,amu, t�ac -�, ,� LOT NO. b No. sraear APPLICATION FOR APPLIANCE PERMIT * CITY_ OF.CLIPERTINO Date JUN fi 19fi� 196..... Permit No.—L'_�` Fee S-49--1 • a-5 Application is hereby made to the City of Cupertino for a permit to install gas appliances as listed on the reverse side hereof, and agrees to install said appliances in accordance with the provisions of the Plumbing r':ode of the City of Cupertino, and all other laws applicable thereto. Use of Premises_ ro K in Owner�y4l�-ru/ /w►-vwctw_� _ Address_ _ BY Address_ ACTOR, AGP.NT MdC & SHEET METAL CO. Approved I� t80 E. SUNNYOAKS AVE.. CAIdPBELL. CALIF PLUMBING L's" TOR w. JDm = ❑ ,� B awl E3 n o R ot ^ 7. n ON -Ti 0 <' 3 9 0 ^ IRS j N IJ IJ•.N IJ N � �� i� N .p, tH N ^.. � � J � V7 .p yi N O '� W J [.� � .p. tN N �-` 1VL. \ o y � I, °o e w � �' ama " a is lJ � � 9y� b0 . U� ���v r`7 N i maz = A o� o C N i ivy � v�v N Omj '� (gip mOz Cl ozm _rt o i�.Q a Z n D Vim C O�Z a moan �o m TE M P 0 KIM). 'kS SERVICE DATE: ----------------- ....... . ........... ...... Fee: ......................... OWNER: ---- AT: .... LOT: .-- r.--------- ... ............ ------------------------------------------------------------ REASON: The undersigned agrees to be responsible for the gas service at the above location,: until the building is ready, fo pancy, and is released by the Building Department, City of Cupertino. %�O >I- . . . --------- ----------- -------------------------- - -- -------------------------------------------- TENANT OR OWNER TEMPORARY),P),dAl SERVICE 7� - DATE: ------------------ ... ..;..... ..................... .... - ----- Fee: --- .. - -- ...... ... ............... OWNER: ...... ---------------------------- r4Q AT: ...... ------------------- -----------------r LOT: ------- ------------------------------------- -------------------------------------- REASON: .... ------ --------The undersigned agrees to be responsible for the gas service at the above location,. until the building is ready for occupancy, and is released by the Building Department, City of Cupertino. � -------- --- -------- Com". . . . . ...... 117 1/63-500 TENANT 0R OWNER JT INSPECTOR