1612 (2) I �ZI � Ci ➢ ������`�1151 „ I o. � ,
® miFOR GAS PERMIT
CICUPERTINO
�APR 13 19621 /
Date__{�PR 9 1962 195= Permit No.
CITY OF CUPERTINO Fee $ a �
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.
Use of PremisesAPARTMENTL�
7�7 94 leu
h Owner PHILIP RAFALOW, INC. Address
By- Address_
200 rl$hCfl I�rierRACTOR, AGENT -
Pho?tTPbell, California I Approve
Phone 377-5660. - 1. RLUMBING INSPR OR
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