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363NO. • STaRRT sv APPLICATIO JFOR APPLIANCE PERMIT CITY OF CUPERTINO-- Date, 19G..... Permit No. Q :\ Fee f 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 slid !' appliances in accordance with the provisions of. the Plumbing Code of the City of Cupertino, and all other laws applicable thereto. Use of Premises �+ uq i r7i Owner Address By -a • Address CyyNTRAC3*0R, eNT Phone4_' (� / // �' APpro LUNRING INSPRCTOR 7_ Gr nry� N OFFICE r ZOFY GAS SERVICE E BUILDING INSPECT IiIC CITY OF CUPERTINO a 7 .............. .. ..... To You are hereby author to connect he GA ice f �ori!e . --.,•* ................ Owner or Tenant .... ...... .. ; a, .......................................... At ... .. ......... New Service .... ....... No. of Meters ...--1.............. Rboonnect .............................. Move Service ........................ No. of Add. Meters ..............Move Meter . ...... ........... LS............. BING --- ------- 110 7/61-500 -t-A