776 (2) . �a a� b �� �� �.� �m No. � i
No. sraeet
, APP�T�N FOR APPLIANCE PERMIT
� OF CUPERTINO
� Dat 1 �196..... Permit No. ��_
� / �
^I �/ (�[ Fee y_(p__
� lA�plicaA�p6 is�y����ae City of Cupertino'for a permit to install
� gas appliances u listed on the reverse side hereof, and agrees to insta(1 said
� applianms in accordance with the provisions of the Plumbing �:ode of the City
of Cupertino, and all other aws pPlicable thereto.
,� R�o,��m�es E E AL, IfV(.��
y Own _ Address
��� - 22313 MEEKLAND AVENUE
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