1726 (2) LOT NO.
NO. STREET
`MA 1 FOR GAS PERMIT
® Cl F CUPERTINO
MAY 111962
Date ,A I-, 1, , 19� Permit No.
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� CITY 01• t11PERTINO. „ , Fee $ �
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 accordancewith the provisions�of the Plumbing Code of-the City
\ of,Cupertino, and all-other laws applicable thereto.. -
Use of Premises APARTMENT ?F Y C
Owner PHII,IP RAFALOW,.IN _ Address
By Peri; kng, Q Address'
fl$ TOR; AGF.NT
,• Phone Campbel_f,'CaliforniApp
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S. IOnC 7m5660�.. y.+ '` PLUMBING INSPECTOR
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