2075 AST
NO.CJkN FOR 6ASPERMIT
NOV 6 962OF CUPERTINO
Dat��aaOCt._ 1•_�n�2j fl 195_ Permit No. 2o.7-r' ;
Y VI V 1IrtR 1 117V Fee$ i
Application is hereby made to the City of Cupertino for a permit to install gas pipes"
and/or gas appliances as listed on the reverse side hereof• and agrees to install said 'pipes
and/or appliances in accordance with the provisions of the Plumbing Code of the City
of Cupertino, and all other laws applicable thereto.
8 Residence
Use of Premises ,
Q Owner. �eep Cl ffe):lvlgydPAQ•. Address Lo 2 And a.
i99 G*Q�.f,A�9 0AL VAM `Address
hone "•'QPProve
PLUMBING IN RG R
--
v
ro m b
:OA i ...7 t `nn�'
-,MJP Y - GAS SERVICE'
DA .......... Fee:�S.........................
11
OWNER: ... ......10
..............
CITY OF C%11P R
AT:
LOT: ..... ..... ........................................................................
REASON: .-- .. ... .. ..... . . . . ............................................
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'The.undersigned,agrees to be responsi fo the gas service at the above location,
until the building is ready for ocqupa;, and is released by the Building Department,
City of C4
P ne
....... .............
INSPECTOR
................ .................................... .........
YT OR OWNER:
117 1/63-500