1614 (2) NO. STREET
APPLICATION FOR GAS PERMIT
+1 QF,,CUPERTINO
Date ,n�q 1 Permit No.
Hr K �I.rj ' 1`.� L o.o
1E
Fee $ c2
Appli 1�ys e�y ,�yUIFI r f Cupertino for.a permit to install as pipes
�p is �e sted o the? 8 P P
and/or gas app lances 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.
a Use of Premises APARTMENT �E (11 E� �\ ® t-rj
Owner PHI/L�IP(�R/AFALOW, InNC. i Address «�
By-7 ' 7�Cu "'41 J"nc- I Ad res
ZOO CrIS 'CfI 1Qt11S1'RACTOR AGF.N'P ( I
Pho",Aell, California I Approv d
one 377-5660 PLUMBING INSPP, 01
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ro o.
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