270 (2) r t Is #13b r ,_.
LOT NO. i— a
NO. 5 u•LeW Zt
APPLICAT, . . OR APPLIANCE PERMIT
OF CUPERTINO
Date r WherebyNde
196.---. .;Permit No.SiFee $
C-VQ Applicationto the City d'f Cupertino for a permit to install ,,;,
Q gas appliances as listed on the reverse side hereof, and agrees to install said
appliances in accordance with the provisions of the Plumbing bode of the City
of Cupertino, and all other laws applicable thereto. f 3
Use of Premises Res .
Owner_ Rousseau Org. Addres 582AAirketS S F.
SANgy OI SHEET META Addres
.�ee 779 OLD:
.`1��,�PF.6rtAt r'n Rl r)S rei mrp•ne Approv
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