761 (2) LOT NO.
NO. STREET
�AAPPLIANCE PERMIT
Gam+ CI F CUPERTINO
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EPR 13 1962 TGA .
Date 96..... Permit No.
CITY OF CUPERTINO Fee a
Application is hereby made to the City of Cupertino for a permit-to install
t gas appliances as listed on the reverse side hereof, and agrees to installysaid a
appliances in accordance with the provisions of the Plumbing bode of the City
of Cupertino, and all other laws applicable thereto.
Use of Premises' ` (�
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