269 (2) 1 /rri�vy A (�
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NO. seT,, '" AaWi]A
RAPOR APPLIA tt`-E PERM
SEP 101960 �.�t; OF CUPERTIi
Date 9/23/60 196.... " ml
t CITY OF CUPERTINd t l
L
Application is hereby made to the City of Cupertinoyf� a; . rmi o install
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.
k Use of Premises Res .
rn Owner Rousgeau Ong _ Address " g_F�
I' $AN t'�RLOS SHEET METAL WORKS, INC '
C Address
' 779 OLD CQ&Wkk ENT
y ¢4j'_�f Pg&N CARLOS, CALIFORNIA �u., Approv,
'_ PLUMBtKG INSPE
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