1717 (2) mZ I C.`. —
_NO., STREET
PA IV FOR GAS PERMIT.
® CT^ OF CUPERTINO
Date
Y 11 962 ' �'r�WPermit No. 171 "T
(1 r p p'{ �'
O
O TY F CU Eft I �NO Fee $
AV, ion 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
and/or appliances in accordance with the provisions of the Plumbing Code of the City
of.Cupertino and all other laws applicable:thereto.
v ,
Y Use of Premises APARTMENT S
n Owner PHR IP RAFAI.OW 1NC. j Address
t 3.
r, ay_- 1�..r, rLML.,, 4 Address
Ic ..'-ZOO CrlStiChtVEC`ACTORI A f l
PhoG2mpbell. California I Approved
�_ _ _ phone 37M66O - - PLUMBING INSPECT R 'r
IL
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