595 (2) FEPPT1;RTRF'r'. 7 AT F LOT NO. '
No:-'r _ sTRBeT
e' .1. 'A%
^FOR APPLIANCE PERMIT
TYOF CUPERTINO
O.CT 3 D 1969 u ;
Date ry—`d:Q61 196----- Permit No. �
CITY OF, CUPERTINO Fee$' 150
Application is heieb"yumade-to theCityof Cupertino for a permit to install
gas appliances-as listed-oh' r'the,reverse,side'hereof, and agrees to install said
appliances in-accordance with ahi-'provisions of.the.plumbing bode of the City
ofC ppertinoand all other laws applicable thereto.
s
.� '` residenc'P
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Use`of Premises
J Owner' $ r, .._ Address rnn
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r5. I man. l'vixncttm,
Address
plane++Kb C9:'�C�[$'SIPal01 Approve
PLUMBING INSPe OR
:�; 'C: v, n �' 7 ❑ n .n '-1 w $ o00 0, Kf � n w'oo
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SFJ _____r
T l � i N
N GAS SERVICE NOTICE �l '-t°orCE
BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTINO '
.> To a
..........
` -, y•' You are''hereby%-au_thorized to connect the GAS service for -
Owner or.'I'enant
At.. . C�
t P
v • .::.a t..,.. .
New Servtce-: ......:------------
No.- - -of Meters - ./-.-- --- Reconnect .::..,...e..........
......"..
Move Service
........ _____
'No. of,Add.-Meters ----------- --• Move.Meter, ..........-
�`� kl4 ~` PL�MBINGNINSPECTOR�
J 110)1%60-500 ! r