1022 (2) . �I'�N A I✓ LOT NO. LO t"'#28 -
NO. �EH Tract
N 60,
100 1 APPLIANCE PERMIT
OV62C i pF CUPERTINO
Date 11/7/62 196..... Permit No.
CITY OF CUPERTINO Fees ' Lot S
N
Go Application is hereby made to the City of Cupertino for a permit to install
gas appliances as listed on the reverse side hereof, and'agrees to install said
appliances in accordance with the provisions of the Plumbing rode of the City
of Cupertino, and all other laws applicable thereto.
Use of Premises Res. -
8
h Owner Camino Dal HOme9 _ Address-_
SAN CARLOS SHEET METAL WORK ,
gp p� ° Address rt
o
Phone LYO —G�1,5scewr
Approved
I ; PLUMBING INSPECT R
Rte _
9 N
n' ct
'w _________________
� N
c : T RN
_y
9 A '
QFFICE
GAS SERjIdFNOTICE torr
BUILDING ,INSPE, -'TOR'S OFFICE
CITY OF CUPERTINO
---------- /-' 4It 9G
To
You are hereby a Ut49ed to con ect the G rvi e or _
Owner or Tenant ... - ----
i
------------
-------------------------
Ne"w Service .✓.-.......
No. of.Meters ....1:.......:...._:. _ Reconnect ....-...-- . - -
'Move Service --------
No.
. ...No. of Add. Meters Move Meter ------------------..--
....... -----
PLUMBING INSPECTOR
r .110 7/61-500