1472 (2) 89o � LOT No:
NO. STREET ,
M FOR GAS PERMIT
CI F CUPERTINO
OCT 3 rssr
Dai 0QT = 195_ Permit No.
<<CITY: OF VU PLUM Fee $
Application is:hereby made to the City of Cupertino for a permit to install gas pipes
(h_( and/ni',gas appliances as listed on the reverse side hereof, and agrees to:mstall said pipes
l and, orY�appfiances ,accordance with the provisions or the Plumbmg-.Code of the City
ofrC9 ert1, '.Viand.all�othe;y�3ws.wppkcableittrreto:
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Use of a Premises_ .
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Phone ��-//VV A rove
' PLUMBING INSPECTOR
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