803 (2) /S
' LOT NO. /
NO.
I� d �0,11CUPERTINO
PPLIANCE PERMIT
�(�91aY 11 19 UL
Date APR 2 6 1962
Permit No.
CITY i INO— Fee 3 4'2
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 Pr
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PHILIP. RAFALOW, INC. •`�, , � C
u ' Ownei . : : - Address JC'
gy [um�ia _ 1 Address
(ISt1gTCTOR, AGHNT
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on�amPbelCali(ornia. PP
Phone 371-S66P ' a s i i PLUMBING INSPHCTOR
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