431 (2) LOT NO:
2 1 °� sTaESTCcG� �2/65'.
APPLICATION FOR GAS PERMIT
� ' OF CUPERTINO
Date — n S_ Permit No.
N
I,&! APR 29 19bg
Fees
A he It,* haM CityofCupertino-for a permit,to install gasp pipes
"4•' ! and'
s p� nce is n e-reverse side hereoCand,agrees,to,install.said pipes,,
a.-and/or,lappliances in accordance with-the 'provisions•of the Plumbing Codeof the,City_, ,
- of Cupertino, and all other laws applicable thereto. ,
Use of Premises ✓
G ddress
HICKEY SlNet'_ Address
„ (1' y r'.QONTaACTO$T(:4GENT /� D
Phone•
Sunnyvale., '� Approve /
di i i_ i ITj, PLUM BINGJNEPHCTOE �
n C) w
' >c.�ti a vfe `° > n i g � � 3 a o 3 _n rEe �• 'c —I 7y�` .
7' -
t
r.:
GAS SERVICE NOTICE . OFFICE'
COPY
BUILDING"INSPECTOR'S OFFICE.
CITY OF CUPERTINO,, .`:
r �
'To
YYou are hereby authorized
to conned the GAS service for
Owner or Tenant ?�A,..�/2 ..... ,At .-------------- .............
:..:...
- --.._........_----�........._................... .......
- - ' New Service ./i...... .
• - No. of Meters .. - --- ... - -• ,� - Reconnect ........... .. ......
Move. Service .....
No. of Add: Meters .............. ' ": Move,Meter' ..........................
I
T
WGI�SPECTOR
- ,Ito 6/59-500 - a:, •' .