1618 (3) NO. TR88T
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LAGA ON FOR GAS PERMIT
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�l"tl � 1 Permit No. � btF
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CIT F r PERT �(� Fee $ .�
APP lica'tro9Fher'WIY RItl 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
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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aUse of Premises APARTMFIu -/� cZ/
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PHILIP RAFALOW, INC. ,
Address
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'Z00 Ctistich(infr RACTOR,
AGP.NT
.;Pho�2mpbell California I ( Approved
Phone 3775660 i ; PLUMBING INSPECT
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0. 3 GAS SERVICE-NOTICE - or•EtY ..
BUILDING..INSPECTOR'S, OPPICF. COSY
CITY Ol'-.CUPE TI O.
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`5 -- ��.� - ... ......... 196.7-.
To
_ You are,hereb�zed to connect the service for
Owner.or Tenant ............ at
- — -- -- ------ ...At .._....�. -�..�.. .9 . .................... .. .... ..... . �
C?..i�'.. ...
^� New Service ...... .............
I No, of Meters ....... ....... Reconnect ............................
f.
Move Service ------------------------
fy"No:•of Add. Meters Move Meter
i. PLUMBING I CT
110 1/60.500 a. �,