1623 (2) o ,
• 1 (7 r r12 �r� �,• t�� ' ��OT N ��
NO. STREET
0® 1 1 FOR GAS PERMIT
1<i CUPERTINO
f 9APRR 1]2^3 1962 � /-
Date 'r9ffL _ Permit No.—"7-
CITY
o. `"Z
o_
CITY_ OF CUPERTINO Pee $ �.
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
and/or appliances in accordance with the provisions of the Plumbing Code of the City*
of Cupertino, and all other laws applicable thereto.
APARTMENT '
Use of Premises
n Owner PHILIP RAFALOW, INC
By
.
Cp�TR 4 Address
�. . 200 Cfl$tlCll Ld lltl CTOR, AGF.N •
Phonq Approve Y ~n
Ti u r T
PLUMBING INSPECTT ORI I
t,;Rbnnn 777.1Arn_ r.. . °...•t .4-� CI.��i•' . _ �._,
N O 7. N I Nl C) n b7 (l E
to G bo N ^ N
p n rt � Y n _...� ❑ rt e w,
c ------- -----------h
v \ rt
T
ki