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1067 (2) J�//�A� LOT NO. -ND. STREET . APPL-1 ATION, FOR APPLIANCE PERMIT © E� Crll' OF CUPERTINO Date 196..E Permit No. (/ 7— Y `n1 Fee s CApplicatio is he�by madelt,(tlhe City of Cupertino for a permit to instal l gas appliances as listed on the reverse side hereof, and agrees to install said O appliances in accordance with the provisions of the Plumbing f;ode of the City of Cupertino, and all other laws applicable thereto. Use of Premises r 7 Owner Address 41NSPBr�R 13 Address ICONTRACTOR, AGENT PhonG -�� Approve PLUMBING E /9 *g � $ 0 y / Bw ! � > � 7 \ \ - ---- -------- - » \ « ƒ - -w �----_ ___- __�----- -- � -----� - ----------- ---- -- -§ � � -- -- ---�/ /2 � � I \ ■