2229 (2) LOT NO. ! 7 V
NO. STREET
APPLICATION FOR GAS PERMIT
CITY OF CUPERTINO
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Date '-1 `�� �� 195_ Permit No. 9
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Fee S C)
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V 1 Application is hereby made to the City of Cupertino for a permit to install gas pipes
and/or gas appliances as listed on the reverse side hereof, and agrees to install said pipes
and/or appliances in accordance with the provisions of the Plumbing Code of the City
of Cupertino, and all other laws applicable thereto.
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Use of Premises '�
v Owner 'l L/SS U Address ��')
By 4J/L,J LC�—�l a n3tn� Address 1 S0
CONTRACTOR, AGRNT
Phone G L ( �1 0 Approved
PLUMING INSPECTOR
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GAS SERVICE NOTICE OOP),
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BUILDING INSPECTOR'S OFFICE
CITY OF CUPER i O�
__........—� I �...�. ......., 196
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To 1
You are hereby auonnect the GAS service for
Owner or Tenant .....-... ......
...._. .. .......... . _.. ............._...k-
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nt .........�..C .'�_(6 ._. t�l� r. .................
New Senice ..... -/.-
No. of Meters _ .......I........... Reconnect .................. ...........
Move Semite ..........
No. of Add. Meters ...... ....... Mov er .._...................-.
PLUMBING INSPECTOR
Ito 6/63-500