1028 I _
LoTNo. 434
No. sTaeeT r t' Tract 43150 '
APPLICATION FOR APPLIANCE PERMIT '.
CITY OF ,CUPERTINO
Datef8
11/7/62 . 19G 1 ..... Permit No. • b/��-
p ' / ZJ
Fees L/
0 Application is hereby made to the City of Cupertino for a permit to install
,--I gas appliances as listed on the reverse side hereof, and agrees to install said
appliances in accordance with the provisions of the Plumbing .ode of the City
Y
y$ of Cupertino, and all other law's applicable thereto.
Use of Premises Res
u '
A . OwneCf!
amino Del Homes: '; AddresP 0
SAN CARL SHEET SHEET META-- LelUp
7 Ot1) CeUNT� Address l t n
SA CARLOSL�ClicL9T�a, nGaNr
hone Approved
P UMe1NG IN 9 P8CT' L
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