575 (2) LOT NO.
C1` NO. STREET
RR6 FOR GAS PERMIT
I CUPERTINO
Dated 195-(- Permit No. -7
CITY OF CUPERTINO Pee s1'%
1_ App ication is hereby made to the City of Cupertino for a permit 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
of Cupertino, and all other laws applicable thereto.
a Use of Premises
u .
.n,- Owner. �n�.LYd��siv�c� Address
. ByL kr-ia_ � }P.AV,' tz' :•' I- - Address 71-� mqT �e".:Yer^
3ti
CONTR ,GENT
PwnemApprove
,
PLUMEING INSPECTOR �'.'�
V A O �
`O !I Vl 1 N Il N n N N N w
� N
ro o. C
� Y 7
A _
3
—w
i ro 'm I v
11 \e
4
GAS SERVICEN ICE OFFICE
COPY
BUILDING INSPECTOR' 'O FICE
F
CITY OCUPERTI1O1 "
------
To. C _ .
.-You are hereby authorized to connect the GAS"service for
Owner or Tenant.. .. ......-......................- `. ,_.. . '
A.a i.... ..71
...-.. -...... :........... ... ........:a:..
At . ..-
• -
New Service
�. No. of Meters ... - '
.. ._ Reconnect-. .. , .. . . .
:•,,: ., .Move
Service`..-
No. of Add.'Meters ........::::'.., Move Meter ............ .
.
UM INPECTOR
110.6/59-500