470 (2) DO ( LOT NO.
No.
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APPLICATION FOR GAS PERMIT�2�
OF CUPERTINO
Date �9 _ Permit No. a / �7
4 I t
Fee.t
A fflWor0fhe�et tfflTj ity of Cupertino fora permit to install gas pipes
and/or gas appliances as este on a 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 allotherlaws applicable thereto.
. Use of PPrremises_
r7i .
Own e' r/!-GCS L,4— /`s,fX—�L' :_ Address--/
W. L. Hi(;KE'f fluty ,, TRG.. - r
By Address_ _
6unriyva `e;T+°�lia A roved —tet
Phone- PP,
- - PLUMBING INSPaCfOR 1
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CERTIFICATE °,OF COMPLETION
BUILDING INSPECTOR'S OFFICE':
ill& ' CITY OP•CUPERTINO
D1te
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. No.-
The Building Permit No
The, Building
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Located;at ��:.R l^ rlr�r eJ y r �•............< ."'"
........
Owned by r'x'.".� .`:. r'"Ct� ✓' <?. ..
ri
e
" (Completed);
Has Been f or Use As ....'Js:
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'A'611-DING-INS:PECI 6R'+-
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