581 (2) LOT NO,
NO._:rj STREET -I
•L
I
APPLIANCE PERMIT
F CUPERTINO
18 ig6'i -
'Date /•Y 196--- Permit No. a
QUPERT.INO, Fee s_
;
A, QF
Ap catlowis:hereby made to the.'Clty of Cupertino for a permit to install
gas appliances as lis'ted'on-thereverse{s de hereof, and agrees to install said —_
r.
r / . .:appLia vnces in accordance`aitfi tti sprovvisions of the Plumbing erode of the City
Cupertino, and all°other laws applicable thereto.
Use of Premises
�" Owner Address —
4- Address— ——
'�.^y. HEATING & S9t' TRA�P1q}f?", c _ c
ya-, gGilriNronKc avF .Rr n+caFii rai"ar Approved
"` T: PLUMBING INSPECT
nyrn� Oh $,� nw (l4� X61.;? i
n
b �
o •
a
A t
�� � __ � �__v -��________�'`SST••