1676 (2)�®. 41i�PP17C'A�II OR GAS PERMIT
1! tJlf1'f 11 19 ':'CUPERTINO
Date. APR 2 6 1962 Permit No. A; 7
?: CLT Irl 90
Fee $
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
Jand%or'appliances in accordance with the provisions of the Plumbing Code of the City
T •' *bf Cupertino, and all other laws applicable thereto. '
At Use of Premises ' Qg iad
V) Owner +y' ' 't , -Address "� •c. __ _
By flu• Address
S rj.p'•CONTRACTOR, GENT I��'I'77_
V PLUMBING INSPECTOR
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