2531 O( �� f�Ol�q,(,(,GLI �MIVI I.ux-- LOT NO.
NO. ® C (f Tl�
P.PLIF,JVION FOR GAS PERMIT
i `- E`CITY OP CUPERTINO
x o 1 AUG 21 1963tt_
° ¢ Date- Ll n/IA4 /ff 1962- Permit No. rJ _
3V C:I�
= o I Y OF (;C, ERS'��n
Pee.$
Application is hereby made to the City of Cupertino for a permit to install gas pipes
o Wand/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.
a Use of Premises RQAtC'po/t\,N
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Owner 1� ooAld �lYy{1 _ Address �/1Atd10XQQ
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° CONTRACTOR, AGENT
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a o State License , Approve
-U PLUMBING INSPECTOR
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