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