755 (2) QAb-7-S'7 I�Ye..�PPo� .-�r� LOT No
NO. 4:
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A , 4:IN APPLIANCE PERMIT
AD !i 'Y OF CUPERTINO
�J��JJ// t7 3 D 1962
Date a 9 , 196..1 Permit No._7�
Y OF CUPERTINO Fee $
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
appliances in accordance with the provisions of the Plumbing rode of the City
of Cupertino, and all other laws applicable thereto.
Use of Premises A
u
i Owner j O.E.,-,.r,...,� _ AddressLilj uL GF
Address
CON CTOa, AGENT
Phone UC E 6—1-1 Z Approved
PLUMBING IN; E
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