1239 (2) o20Z G/ y//Grll lle U (G LOT NO. J
NO. STREET
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RPLI�r7CplZ� AOR APPLIANCE PERMIT
�S',MAY 24 1963 OF CUPERTINO
Date 196 Permit No.
!� CITY OF CUPERT'''' Fee f_��
a Application is hereby made to the City of Cupertino for a permit to install
gas appliances as listed on the reverse side hereof, and agrees to install said
V appliances in accordance with the provisions of the Plumbing Code of the City
of Cupertino, and all other laws applicable thereto.
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Use of Premises
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ti Owyyn��e i!/c��� , L _ Address
BY!����!_ ENr Address
CONTRACTOR, ALCE'N'T ------+G �`tlilk
Phone .J,3�_f/1 vL3 Approved _
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