2058 (2) A PLIC 1 TJION FOR GAS PERMIT
�NOV 1 y R4 'CFf'i' OF CUPERTINO
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3� I�at�ITy OF CUPERTIN,Q96_ Permit No. o�SS
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0 Application is hereby made to the City of Cupertino for a Permit to install gas pipes
o a and/or gas appliances as listed on the reverse side hereof, and agrees to install said pipes
i N and/or appliances in accordance with the provisions of the Plumbing Code of the City
w of Cupertino, and all er laws ap ble thereto.
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OPPICE
COPY
D GAS SERVICE NOTICE
BUILDING INSPECTOR'S OFFICE
/ CITY OF CUPERTINO
To - - ' -_ _- ------------- S-. �.._. .... 3
I,�.
You are hereby authA�/d to cooVt the GAS mice for
Owner or Tenant ----- _fie... .e...
At ...._ ..�.l..� ._--
- - - -- --- ----- C*-�r.----
-----
--------....---_......
New Service 4-�
No. of Meters ...�./�...--.._...... Reconnect ---.-.
Move Service ....._.............._.
No. of Add. Meters Move Meter ....-..
. -....-----.....__.....
PLUMBING INSPECTOR
110 7/61-500
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