567 (2) LOT NO. b4'
O: STRBET -
API4QAT ON FOR GAS PERMIT'
q F CUPERTINO' '
Date g. Permit No. S
50
TT��// ((��[[ (r� pp[[pp'T{ pp��n Fee $) "/
�11 A�L-TY-o,QRerbbPISiLR1[KQity'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.
aUse of Premises
7 Owner 01 Address
By GU]��bS_tTflatui C� . Address 6 a c c �'FJ
h' 1 CONTRACTOR,, AGENT / e 1
Phone , ' 01 1 ApprovedL/L ^z�
PLUMBING INSPECTOR raw;
NI4� z N mw C) C) al
.,-
�
y ry --------
_
-------------------- H:
G1 ° n
' z
E �
i
------
z
moi : �nr
I GAS SERVICE NO ICE OFFICECOPY
COP1
A; � ' BUILDING INSPECTOR'S' ' FICP '
CITY OF CUPS(TINO
CCC777
�. . .. ..................:..
To ; '
You are hereby authorized to conned the GAS.46gce for
Owner-or.Tenant ... . ..
... .... ...
...
At o ...i.... ......... .......,... ...:.......
C vy�'....:- -' .... ... ... .
.........................::...................
New Service .: ...............
No. of Meters ...........:.........
:: Recon'riect
.------------------------
. . ,Move"Service ............ ...,
�No.•of'Add. Meters............... Move Meter ...................:......
�s"e......_... .
' .• y. PLUMBING INSPECTOR
110 (/59-snn