222 (2) LOT NO. #103
No. /srxaer Idlewlld
APP �YJ� FOR APPLIANCE PERMIT
I� COF CUPERTINO
�'i960�s�o 1
Date 196..... Permit No.
CITY Q� CUPERTINO Fee s /- sa
Application is hereby made to the City of Cupertino for a permit to install
egas appliances as listed on the reverse side hereof, and agrees to install said
appliances in accordance with the provisions of the Plumbing rode of the City
y of Cupertino, and all other laws applicable thereto.
2
Use of Premises Rag
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Owner Rousseau OPK. _ AddressP () hox a 207
SAN CA$ OS SHEET METAL WORKS, 1NG Address Hayward
9 OLD COInceNr
Sn�ARL05, CALIFORNIgApproved —./'1- -�'�-�C
/ PLUMBING tNsrecroa
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