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2083 (2) I v`` �G+I-ll) � � �n�OT NO. 1 l• NO. MEET S,A.,Ps,`PLICATION FOR GAS PERMIT z i END /�. `t*. ITY"OP CUPERTINO x0 I ,' 0 < DatC U q � 7 � Permit No. '7����J, i a Fee'$— o A 1'rn 'onpp'sthereby r�gd�[q ghg�ity of Cupertino for a permit to install gas pipes O < and/or�A��i pli'dtSms asl�i felsnit6�'Iteverse side hereof, and agrees to install said pipes im and/or appliances in accordance with the provisions of the Plumbing Code of the City a w of Cupertino, and all 1 r lawZle thereto. w x r Q� 0 a Use of Premises o0 > ui 3 Ow er Address oa ZAzJ (� z Address / J 00 011' 41A w Z 0 a 11 Z �� Approved .�`i.'z/, o 'tate License� _ U CONI'HA II ACF '1' « \ � ƒ \ • \) \ ! ` ] , ! [ 2 } /% . % \ \ (n7,3 ; } § ` 1a -- / \ 7 / { E � � r me /} {� TEMPORARY GAS SERVICE D -- ------ ------- Fee: ----- ---------- ---- - ----- FO F R,. .j it _ .__ ___ _ lslut;t-, T: ---/ 0.'3J01...&---- 0­-.*...,- CITY 0( CUPE-tWh LO ,;� ........e-,. ------ ----------------------- ------------ R REASON: .......... nd gas service at the above fixation, e undersigned agrees to be responsible o the (intitthe build' d f iijg is reads, or occupancy, and is released by the Building Department: City rti o. 4-- 1 i Phone -- - --- -----/ ------ -- ------ -- TENANT OR ---------------------------- INSPECTOR OWNER SPE 117 1/6MOO