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LOT NO,
Wz JUN lZ��bp 1 ION.FOR GAS PERMIT
1 CFTY OP CUPERTINO
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3 < DGITY &6C IPFRTITC) 1963 Permit No. 3�
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° Application is hereby made 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 N a d'/or appliances in accordance with the provisions of the Plumbing Code of the City
a w of',Cupertino, and all of r laws applicable thereto.
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3 Owner / Addres
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< o State License l s / s�3 y-�"s ` Approved RFId EVIRu
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f` t PLUMBING INSPECTOR
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GAS SERVICE NOTICE OF YE
BUILDING INSPECTOR'S .OFFICE 3
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CITY OF CUPERTIN t
.................:.............. 96.
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You are hereby horized to conned a GASas ' e forOwner or Tenant ....... . ..... ....................
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At
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"New
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New Se ice .. ':`... ... ....�
No. of Meters ........:. ...........
"".. Recontied ...-..........................
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No. of Add. Meters ve e r
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PLUMBING 4NSPECrP&f
,. Ito 6/63-500