784 (2)LOT NO 1�7 2N
NO. STREET <1 IS
MY12ft •APPLIANCE PERMIT
:fi CUPERTINO
Date19`21962- .__ ;Permit No. 7o
r.c
a . CITY OF` Pee s/.
.Y. Application is here y.- ,I td tlfd�ity of Cupertino for a permit to install•'
gas appliances as listed on the reverse side hereof, and agrees to install said
appliances in accordance`wittiSthe provisions of the Plumbing rode of the City
of Cupertino,agd 411, otherwlaws applicable thereto.
r. ""++ APARTMENT
y •'Us' of Premises
Oner PHILIP,RAFALOW, INC-
,rs 4 x ASS„
_ M _ rAdd�ess�,a—i
F7 'n, nr ,.
1 i IUMBING INSPECTOR
ro
z
�
m
C
�
n
H
N
'O
O