1462 (2)/ L_O G. La Z 4AJ LOT NO.
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APPLIC*10F
FOR GAS PERMIT
(SEP 2 7 1961 CUPERTINO r
Date V11 1 V Z 6 {t l%p5_ Permit No. �� I
Vll1 U 1\V Fee $ Q..
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Applicatiomis;hereby�made,to.tlie;City,oE;Cu«pertino for ,a permit to install gas pipes
and/or gas appliances as listed on the reverse side hereof, and agrees to install said pipes
and/or appliances in accordance with the provisions of the Plumbing Code of the City;
of Cupertino, and all other laws applicable thereto.
Use of
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PLUMBING
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