300 (2) OS4 I IVo2lhL. �Q, Lor No #156
NO. -MENT » .�FAR
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APPLICA idwm F®R APPLIANCE PERMIT
K' OF CUPERTINO
Date 11/3/6O . ....., 196..._ Permit No �
Fee= ' ,�
Application is hereby made to the City of Cupertino for a permit to install
p gas appliances as listed on the reverse side hereof, and agrees to install slid
appliances in accordance with the provisions of the Plumbing rode of the City
of Cupertino, and all other laws applicable thereto.
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fn Rousseau Org. _ Addces 5 2 Uriet St.
SAN CARDS SHEET AAFTAL_ norg, IRI(•. Add $ ra isa0
at.! 779 OLD COUfd9'f''k!§'A ,"Gas'*
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PLUMBING WEP
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