51189 (23) No. Street Lot No.��
TION FOR APPLIANCE PERMIT
City of Cupertino
`$7 aJm
CHAN t�� PC1nFa s 5a ??
as
I"'s h City of Cupertino for a pamdt to install Sea appliances as
.5 c ist n tEE nd agrees to Install said appliances in accordance with the
e 8 provisions of the Plumbing Code of the City of Cupertino. and all other laws applicable
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A Use of Promises loo
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3 Owner Address r
O 9 / T Y
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contractor,Agent �
Phone /Ie!ms's
State Idccnse / ?79 a G-sa Approved
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