783 (2)LOT NO.
NO. STRIET
PI R APPLIANCE PERMIT
® OF CUPERTINO
Date f ARF9133 1662 ,3
96..... Permit No.__7,�
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��' �F �IJPQgJINO Fee t/4
I atio Is h re y ma a to, the City of Cupertino for a'permit to install
gas appliances as listed on the reve%se side hereof, and agrees to install said
appliances in accordance with'the provisions of the Plumbing c ode of the City
of•Cuperfirio grid all other law4'apulicable thereto.
PHILIP RAFALOW °INC: 7
rM Owner _ Address 5�F✓ O'Z't .ate
a c7' V �[ '�' z'' I Address— '
200 Fist t -"Y aACTOR, A�HHl`w;
K6neluhell.,_California—� " 1 Approve - _ _ _
t.' Fho e 377-5660— eLll HBiNG Ih SPHCTOR
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