485 (2) A
LOT NO.
NO. STRBBT - '
2 2 48 A L T N FOR GAS PERWTGr
CUkRTINO.
Date ""/'_ � _ Permit No.
Fee
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s
AC{TYonis here3umaae'to'theLit of Cupertino fora Permit to install s
PP Y Y P P 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.
Use of Premises � �
JA. Owner —1 Address
„ByN. L. MICKEY SONS, INC. - Address -�
P. CSORSRACTd10g4GBNT
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GAS SERVICE TICE oonvE
BUILDING.INSPECTOR' OFFICE
CITY OI CUPFRTI
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To
You are hereby authorized to'connect the GGAS`ser`vice.for 'F -
Owneror Tenant,:.. ..... . . ...........r. ......`(/ .......-..............----....
At .:Adl.. - . ... .....
.....
New Service
. - 7777..._.....
..
ice `
No. of Meters ----- Reconnect .............. ' .........
Move Service .....-`....:..........:. ..�
� No. of Add. Meters............... .,Move Meter ..........._._7:777..:,.. , . . . 7777
7777.. ..
s t PLUMBING INSPECTOR
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