2568 fPaS C/�J AL�'t,` AL LOT NO /
NO. STREET ,
_ APPLICATION FOR GAS PERMIT
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0 , Datey 19 Permit No—25
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° rApphcatib� is'hcreby:rt�ade to the City of Cupertino for a permit to install gas pipes
o and/or gas appliances as listed on the reverse side hereof, and agrees to install said pipes
i and/or appliances in accordance with the provisions of the Plumbing Code of the City
Q w of Cupertino, and all other laws applicable .thereto.
0 o Use Of Premises
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a ^ State License 77 - C�� Approves / -n't'-L,IF .
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