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® "&L IZT4% R GAS PERMIT
MAY 1 I I§YUPERTINO
Date ---ADD �(, 195_ Permit No. Z6 /3
bt CUPERTINO Fee $�
�Application is hereby made:to,tfie'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 pipesl
and/or appliances in accordance with the provisions of the Plumbing Code of,the City.- y
'of Cupertino, and all other laws applicable thereto. (• ' --?:• c
Use of Premises �/?� /nw ./
V) Owner/�W,AF4� J. -e/ '�;'1, Address'.
I 'j Approved
Phone:
"•.} - �., K. ! ! 1 r LUMBING INSPP,CTOR
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