462 (2) 20984 I Pepper Tree ,Lane 12
LOT NO.
NO. STR8
14&'
AR APPLIANCE PERMIT
l PR 19 1961 ; OF CUPERTINO
A
,
Date—.4'�18�61 196..... Permit No.
:.CITOF CUPERTINO 5�
_
:; s N �,.�., ;�_.•, Fee E
App��catioy;yis'hertebymaa_ deto themeCity sf,Yupertino for a permit to instal!
1 gas ap`phancFS agih'#edtor�nthekever e•S, a hereof,.and agrees to instill said
r-I appliances m accordance with the ns of the Plumbing bode of the City
.�.. : of'Cupertino, and all other laws applicable thereto.
Residence
ofPremises
rF y David at Winchester
.in�:r Owner_-'C nmtppn,.,A_��ei+tirin"'�� Address
s _A
San _,Jose
J By; '-;Eog�-Sheets Metal Address a_ .,
.: CONTlACT00., AGBNT
pt:one --Tr 8-0 314. APProved )
�'i -PLUMBING INSPBC O
^
00 w d "I
C'
•A
Q'
N a
Y .�• r S
f