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2530 .a(LJ6W R©w1� CX/�+�St4R.R� LOT NO. ! 2 STREET uN°� APPLICATION FOR GAS PERMIT wCITY OF CUPERTINO Wo AU 1 1963 Y R 5 ° aLL Dnte I 196,' Permit No. o C. a 1 �F rl�t'5��.1{.._ Pee$. . Ap lication is hereby made to the City of Cupertino for a permit to install gas pipes o a and/or gas appliances as listed on the reverse side hereof, and agrees to install said pipes i m` and/or appliances in accordance with the provisions of the Plumbing Code of the City a w of Cupertino, and all other laws applicable thereto. vF (� Use of Premises 00 > 0 Oa Owner Address - Z J (� /fin J , By L`n Y�LXI Lv�nO r+�...¢.� Address Ix"p,OWN r 3 F CONTRACTOR,AGENT Phone s�> 7 R— W z a o State License Cab 42 -785' ; Approve )U(f,, —U PLUMBING INSPECTOR / oz - G } omo22e2aa « 2 % , s772\ � ° [ \ \ � � � � - -� \ , \ D�3 ) �\ k Sti � ƒ m \\ © \) �_ (c