472 (2) 1 G.t
LOT NO.
N% STREET
APPLICATION FOR APPLIANCE PERMIT
' CITY OF CUPERTINO
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Date �✓ 1 9 r T 6.. Permit No. 7 Z _
.J APR 21 1961 Fee $ /' `S°
Application is hereby made to the City of Cupertino for a permit to install
gas alof ffes 611st*F ffi f �ide hereof, and agrees to install said
appliances In accordance with the provisions of the Plumbing bode of the City
of Cupertino, Rodall otherlawsapplicable thereto.
Use of Premises / '`g4U'V-�
/Iv Ownev � N to � �Z _ Address _
Address_
_ y HEA71N@49+1�h41£�aM298f°1�C0. —
pII Ig E. SONNYOAKS AVE CAMPRFI i ram Approved _
PLUMBING INSPEC O
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