1449 (2) /9ct 7 14gec LAI)t LOTNO. I O
NO. STREET
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c FOR GAS PERMIT
CUPERTINO
i�`f Date 195_ Permit No.-
CITY
o.CITY OF CUPERTINO Fee $ o .
. Application-is hereby made to the City of-Cupertino fora permit to install gas pipes
and/or gas appliances as listed on the reverse side hereof, and agrm-,,to.insiall'said pipes '
6,4 and/or appliances in accordance with the,provis�nsaof-the-Plumbing Codetof the�Cltyl:':•`
of Cupertino,'and all other laws applicable•theretot
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UseOf.Premises
Owner ` Addces'
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CONTRACTOR, AGENT
Phone G L C G Approve + T'
PLi1MBING INSPECT
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