1595 LOT NO.
NO
APj►�PL1�4TI _� OR GAS PERMIT
CI .EarNO
Date . . I931L� Permit No. /t�y9..5
Fee $_ —
Application is hereby made to the City of Cupertino fora permit to install gas pipes
G� and/or gas appliances as listed on the reverse side hereof, and agrees to install said pipes
and/or appliances in accordance with the pr ions of the Plumbing Code of the City
of Cupertino, and all other laws applicabl h o.
Use of Premis
Y
71 Ow Address
BA. Address
RACTOR,, T ��
P_4Qne NTCT • I Approve
�!� PLUMBING INSPECTOR
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