2087 (2) •_ I U4
NO. STREET
N SAcP�PLICATION FOR GAS PERMIT
GIn' OP CUPERTINO
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3 V prte �NOV 19 1962 L Permit No.
W a h Pee S_
O Afe$iTiVon( �I'rerFlSl' I�eI I[y of Cupertino for a permit to install gas pipes
o a and/or gas apphances a`f'hiStcM'klr>' e rEverse side hereof, and agrees to install said pipes
i and/or appliances in accordance with the provisions of Ie Plumbing Code of the Cit'
a w of Cupertino, and a or r laws a icable thereto,
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.¢i w Use of Premises
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U CONTR.croR, AGENT/
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