911 (2) 1
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�- TITOP ON FOR' APPLIANCE PERMIT
jp CITY COPERTINO
pL1'a 1 �96- -'•� 196.2� Permit No.
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'
Cl"'Y Or CUPER NO " y,' Pee
r,^Applicadon'is hereby niadejto the City of Cupertino'foi.a-permit to install
gas apphazlce's�as listed on the reverse side hereof, and agrees to install said',;, t'
appliances,in,,3ccordance with the provisions of the Plumbing, ode of.the City+ %^?
y �j'oPCupertigo; and-all other laws applicable thereto. -5.1
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:U§6'ofP.remises .r.
r w' v
Address
NTRACTOR, AGENT
hnScp Approved
PLUMB1NG INSPBCr
� N � •.l
O
.t _____ N.. •.T �.
N
R
. 7•, ..1 OFFICE
a COPY
I GAS SERVI„ CTOCE” NOTIE
BUILDING 'INS ER'S°OF CE _
J:.
CITY"OC`UPERTINO'. .�
To ..
' You are here y authorize o conn e GAS service for
Owner or Tenant ---- .----
At,------: --..._.. . . ._.
- f
-- L.R.)
, 'V-`' . . _ ... :_ %"'• � �:. : ;.� �• - " New Service
.............
No..ofMeteis....... ....-..... . Reconnect .. / -
t;
--------`. .. ........
L
Mov 'Service ........._:............
No. of Add. Meterse
o Meter
x �
' .' +�'�'..`. • J' Ir Y .k PLUMBI G INS - O
110-7/61-500