580 (2) l LOT NO. ro
.NO., STREET - -
P § F R APPLIANCE PERMIT
IR if OF CUPERTINO
Date?f� Y 196.. Permit No. �O
. Fee
WYCITY OF, CUPcRTINO
is hereby made to the City of Cupertino for a permit to install
gas,appliances as'llsted on the reverse side hereof, and agrees to install said
appliances in accordance with the provisions of the Plumbing rode of the City
of Cupertino, and allotherlaws applicable thereto.
/ Use of Premises U —�•c-�—�^-c-��
(`jun Owner Address .+-
�� IVI I `= Addres
a� HEATING RFOTAKT29ICNE APE","
PP'.One SUNNYOAKS AVE CAMPS PAI IF App[Ov
PLUMBING INSPECT
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.� h�I 1 I I I>�I�� �. -► I�L. I � ,
V.10Ei'NOT OFFICE
GAS $ER
s .. •�
- BUILDING INSPECTOR' , OFFIC; ;COPi
. CITY OF CUPFRT O -
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;'t-i You'3re hereby authorized to conhect'the GAS service for
Owner or Tenant ........................... .. ......-------
- ',.....
At...._......_1.:.-\'. ... �L o,. :......�. .......... ...1
' New Service ......i ......
No.of Meters ..........(............. .. Reconnect
. . . •. Mobe Service -.------
No. of Add. Meters .......... ove Meter..................
t � � ' < :
PLUMBING ti
ii
..................
INS
y101%60'S00
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