1685 (2) (fie e LOT No./
NO.
Z/CPP U0 OR GAS PERMIT
MAY 111�` Y UPERTINO
APR '2 6 1962 g /6
Date I Permit No. -/
a N T'U
Fee $,
Application is hereby made to the City of Cupertino fora 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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r Use of Premises
r"n• Owner. Address d' - - -
By -Address A
CONTRACTOR, AGENT
•.>. ,.Phone ES -) �.st (; O i , Approved
++1:•.P. „� PLUMBING INSPECTOR
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