381 (2) __. t�� �I /�// l d/1VLi' �`�'✓l LOT NO.
NO', STRBHT -
" NAPPLIANCE PERMIT
OF CUPERTINO
i F B 1 19tt
Date 196.61/ Permit No. _
CITY OF CUPERTINO Fee / sG
Application is hereby made to the City of Cupertino for a permit to install
gas appliances as listed on the reverse side hereof, and agrees to install said
appliances in-accordance with the provisions of the Plumbing bode of the City
of Cupertino, and all other laws applicable thereto.
Use of Premises
u
Address
�G(! By Addres
CONTRACTOR,AGENT.
7-3 Phone �` Approve
;PLUNBIN .1NSP8
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