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2183 (2) aDICJ // �/__// 1.ce LOT NO. 3 _ NO. STREEE VQZ PLI&TION FOR GAS PERMIT CITY OF CUPERTINO FIB 2J 1963 .°�' 3 Date L'1'. Pk.4/I V .2/ 190. Permit No.�O _ _�_ a CITY GE CUPERTINO Fee $ Application is hereby made to the City of Cupertino for a permit to install gas pipes and/or gas appliances as listed on the reverse side hereof, and agrees to install said pipes and/or appliances in accordance with the provisions a lumbm Code of the City Q of Cupertino, and all other laws applicable thereto. ��—°' v c Useof Premises x/01 n/GI( a, n Owner Address1—'1&PSAK4L _ By AZII&PJA4 AM Address 4L CONTRACTOR, AGENT _T I Phone AP Fl-y5aNG INSPECTOR tz o rt n IT, w. n n D. N C) � rt -- > o N n -- b T u z AN — � a