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1250 (2) � - *LOT NO. �l' O_ Q 5 E E 1 Q p� Ap(t I TION FOR GAS PERMIT 'JAIr 2� �t�"' OF CUPERTINO Dae _ - o. � 19T�1. Permit N � V11 VVI Fee $ Z' :5'0 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. 8 Use of Premises /'Z ti Owner�" d , �� � '�' Address I i, Address/yl/� '-'�� ✓✓c+v� /,�/�+ J�J CONTRACTOR, AGP.NT JY-5 Phone ON i- 35f77 _ ApproveAU U 181NG INSPECTOR n G12 0 > � "A rn� � tn� C.) rt Eek Wll Gll Elw � � d n m ? ^ N � a �i O b0 p, "+7 7 •rt w X00 O++ N v u D .c. ro or C ro '- > ? ———————--—————— ITI-- — ——— — — — ——N � N V � —w H : O A p J GAS SERVICE NOTICE i,COPY ®Purr.BUILDING INSPECTOR'S e4 CITY OF CUPERTINO .......................... . ............... -------- 116J.. To You are hereby authori d to connect the GAS service for Owner or Tenant ..... ... . .... .. ---- 4-zz�t-��---------------------------------- ............. At.. 2 New Service ---------............... No. of Meters ... ---------------- Reconnect ...... ....................... Move Service ------------------------ No. of Add. Meters -------------- Move Meter .......................... - ------- --------------------------------- ---------------- LIJMBING INSPECTOR 110 1/60-500