1266 LOT NO.
�93� No. � � staaeT
70 ARP-LICAVIYa1Otj OR APPLIANCE PERMIT
r Y OF CUPERTINO
,Ilii 1Q� tea, /
Date JUN 6 196 196..._ Permit No
CITY OF CUPERT'^
Fee
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 siid
appliances in accordance with the provisions of the Plumbing Code of the City
of Cupertino, and all other laws applicable thereto.
Use of
Premises �Ivt'
83 OMner� +✓tet r X %�.ryw,t� _ Addresses
gy n�V���nN Address 11,1 In
HEATING & SHE 444NpO�oE" J
190 EPbbnaYnnue ev r,eivncli r is Appmv eLt
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