814i9-7 LOT NO.
NO, STREET
P
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ACH-61 1'614 --FOR APPLIANCE PERMIT
OF CUPERTINO
.e M�.y 2�V6?
Date lor 7- Permit No.
1,UPERTI140Fee
P
heieby made to the City of Cupertir�6.10r:i,pefmiie',t6, install 1�s
S. appliances,as liste rb;'t5e'r'Fverse side hereof, and agrA toloStAl said
i ' i -e c' r ance with the provisions of the Plumbing:�ode of the City"of' u "rtio, and all other laws applicable thereto.
Use of Premises
Cb ner Address
• ByJIM Add
CONTRACTOR, AGENT
Approved
PLUMBING INSPi
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NO. `
APAP TION FOR GAS PERMIT
AN 2 1961hMl OF CUPERTINO
Date '��ggT_INO 19�i Permit No.
Fee $
. Application is•hereby made to' the City of Cupertino for a permi6lt ,-install gas pipes
and/or gagjppliancesias listed ion the reverse side hereof -And agrees,to lnsstall.said pipes
and/or.,"appliances`.in accordance with'the provisionPoke
mbing �2o f the City•,
of Cupertino; aijd`all other lawsrapPli abi$"thereto.
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Use of Pr/em/ises
/7 CONT
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Addresses
Approved /:.•.. .� n 1 r
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