1993 (2) LOT NO. 'G
NO. STREET
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APRLIC I FOR GAS PERMIT.
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CITY OF CUPERTINO
'AUG 00 0 1962 U.-Il.
Date ' '195— Permit No._77S.a'
CITY N CUPERTINO Fee s
Application 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
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and/or appliances in accordance with the provisions of the Plumbing Code of the City
of Cupertino, and all other laws applicable thereto.
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Use of Premises
In Owner �`� i Address � �
By
I Addres s ll�oJr
CONTRACTOR, AGP.NT
Phone V 1V'7 Y72 I Approve
,PLUMBING INSPECTOR
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