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LI k N FOR GAS PERMIT
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�$1r NOV 18 1979 TY.OF CUPERTINO
Date NOV 1 7 1959 ' 195 Permit No.- Yl-�
CITY OF CUPERTINO Fee $ 40
Application is hereby made to the City of Cupertino 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.
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m. Use of Premises
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1=4eo Owner �""'�""�'Address � -L
a�By _ Address-
40
ddresszC HEATIN@n&a8FH'F, M 14[.0 "O. ^
'm, Phodi 497 Slavans Cr"k Rd nea Clara _ Approved a//"'r
PLUMBING INSPECTOR
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