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434 (2) •�YL-r%C�C�iCK J LOT NO. ' / I 2 15 P ATI`O'PI\FOR GAS PERMIT V1 � C OF;CUPERTINO _.I Date 5'= Permit No. . .. -.(/�� ��/ (��[[ rnnT ^'� QltT1itatiQ s 1W99T`XD City'of Cupertino for a-permit-to'instalLgas pipes a, and/or gas appliances as listed•on.the reverse side hereof, and agrees to install,said pipes[i.v ,"'and/or appliances'jniaccordance'With.the provisions of the Plumbing,Code ofcthe.City,; 'of Cupertino, and all other laws applicable thereto. s Useof.Premise i '.,OwneC �: /// �i�0D>1>f Address V/»�� B. t d cv 'c n c•'.i�... rAdd[ess y lilt �6 tc r.r� CONTRACTOR) AGENT _ P. O. oo: o r 6 Phone n �,, i I Approve, Otln11p9,ILj Lt�rITTF PLUMBING INSPBCTO0. a w 0 c r � y n ro_ O 1'Tl 1 i n i � Q � _ —w m ^.,