576 (2) ,2I�/�/�' LOT NO.
NO. STREET
P TIOWFOR GAS PERMIT
CIMF, F CUPERTINO
V QC
Date 5 _�j 959 Sol - ` Permit No.
y-o
NO
A�dIR(horTis her-eby ma e o the City of Cupertino for a perm I 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
sof Cupertino, and all other laws applicable thereto.
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Use of Premises P('A +
07, Owner CAP AJ U�'L J 1]r�cJt 1.,0 Address
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By(6 �ss 'ePwlf: Address
COrN�TRACTOR,.AGRNT.:
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Phone ° ' �l PP
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