478 (2) ' LOT NO. /
NO. STRBBT
2 {] 48 APPLICATION FOR GAS PERMIT
�G CITY OF CUPERTINO
Date :r 5_ Permit No. �
IAJAY
QQ Fee $ S l�
App kation iiYh€re�KySNSlf2 to ity 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/oU�p}fan in P-M he provisions of the Plumbing Code of the City
of Cupertino, an`�,all^^��1¢ ble thereto.
Use of Premises ✓l/�
CAI .Owner CL/ly� � Address
�y. L. HICKEY SONS, 1NG Address
ex
P. O.c6lasan6ron, nc —C/^/ �Ecl!✓
'Phone Suen�ala. Ca11h ++� Approved
I I R 1 I I I f 1 I 1 1 i ' I
; PLUMBING IN PBCTORJ
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