763 (2) LOT NO. l T
NO, STREET
PPW 9Nff
R APPLIANCE PERMIT
p(1OF CUPERTINO
h/Dat 3 1962 ,or--.. Permit No.�_
O d
Q TY o QW10Y R11P Fee s�
(cat is f y a e o e City.of Cupertino for a permit to install
. gas appliances as listed on the reverse side hereof, and agrees to install said
appliances in accordance with the provisions of the Plumbing r ode of the City
of Cupertino, and all other laws pplicable thereto.
Use of Premises
ROTH SHEET METAL, IN
223MdVMKLAND_AVENUE
B NA'Add _CAL R IA
_ -
/ CONTRACTOR, AGENT e
. ➢i,nnP pS.[,c� oZ_�83 OO i+ - Approved—,
j,LY ��_ --
�rLUMBPNG INSPECTOR
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-I Tim J