1326 (2) �Q I" 6 2 a l I t 1/ LOT NO.
NO. STREET
1 FOR GAS PERMIT w
Tf
4=40M CUPERTINO
Date
MRS?. Permit No
AM � 'Z 6
.
rlOF CUPERTINO Fee $
.� App a i n is hereby made to the City of Cupertino fora 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, andallother laws applicable thereto.
8 Use of Premises
�n Owner & � p Address_
�By(t (rJ cF�"c Address
coNTRACTOR, AGENT
PhoneU/}� —3S!7 I Approved
I PLUMBING INSPECTOR
w"pp °+.
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t I A
GAS SERVICE NTIE OFFICE
BUILDING INSPECTOR'S FPICE COPY
CITY OF CUPERTIXO
To .
.........................Vlk............................ 196.1.
You are hereby authorized to connect the GAS service for
4��o /0 1
Owner or Tenant .. .. ...........k� W-e
an-
w
At .... -----
New Service ---------------
No. of Meters .... ............... Reconnect ..............................
Move Service ------------------------
No. of Add. Meters .............. Move Meter --------------------------
4 .........--------------
PLUMBING INSP110 1160-500