2059 (2) 142 I���yyI�2U � LOT NO.
NO. STREET -
N mA`PPL'tCATION FOR GAS PERMIT
wC S=OP CUPERTINO
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0 a „ate 9 OCT 2 6 1962 �1%— Permit No. �Gzi
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LL ° AJip�il�ttid�r h� TTt}i!l@ City of Cupertino for a permit to install gas pipes
° < and/or gas app tances as is ed on the reverse side hereof, and agrees to install said pipes
i and/or appliances in accordance with the provisions of the Plumbing Code of the City
a w of Cupertino, and all other laws . )hcable thereto.
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LL Use of Premises
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o ate License71�7 � 5 Approved
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TEMPORARY -GAS SERVICE
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DATE: ........... -------- ........... Fee: ...... ------------------------
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LOT: ------------------ .................. --------------------- ------ ----------- - - ---- ------ -
RFASON: ....
The undersigned agrees toe resFns7ibl7f,, the gas service at the above location,
until the building is ready for occupancy, and is released by the Building Department,
City of Cupertino. Phone
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11 1/63-500 INSPECTOR TENANT OR OWNER