1341 (2) PFPPF/f //LEE LOT NO. -�
NO.® I STREET NsFOR GAS PERMIT
OF;`CUPERTINO
�.�
Date - ,''195_ , Permit No.
y CITY Of CUPERTINO Fee$'`
-4'—�- A lication is hereby made to the Cit of Cu ertino for a erh it to install_ as pipes:
V PP �_ Y Y_ P P g P .
and•/or,gas appliances,as;listed'on the reverse side"hereof, an --agrees to'install,said pipes
�:and%or:appliances,in ccordanie-with the;provisionis—of_the Plumbing Code of'the Cty.F
3offCupe%l no;ind.all.othi:raaws;apphcable,theretor. 7
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se-of Pre —/Q1 S•/ONNGCi': % 'ri
�' Owrier CQMM4"",L-ACTH BLa.PI. _ Address iI
< • �1x'.:�iiAo'r:dL%�iNAiiyG ".,Amim Address- r
CONTRACTOR, AGRNT /
t Y Phone' _ ApprovedLIhJ 1,
PLUMBING INSPP.CTOR
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