1719 (2) N0 GAS PERMIT
+�1 MAY 11 jgy' UPERTINO
Date eL19 �' Permit No'--
CITY PERTINO
Fee $
`0 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
and/or appliances in accordance with the provisions of the Plumbing Code of the City
\ of Cupertino, and all other laws applicable thereto.
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Use of Premises APARTMENT N 3"
`}'"•�L OwnerPHILIP RAFALOW, INC. I Address
By w.aa....,�m� .,M�: Address. .
ZOO Crls}IChCLgWACTOR, A .NT-. I _
Y Phoma be I I I Approved
Phone 3775660 " i,.. =I' EUMBING INSPECTOR
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