427 (2) IM�6 "N-1r i' LOTNNO.NO. TRO�T-
. 2155 APPL*ATION FOR GAS PERMIT
CITY OF CUPERTINO
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Date 1 Permit No...
(Ak 9. 90 Fee $ /, moo
Application is hereby made to the City of Cupertino fora permit to.install gas pipes
and/or ga nes 1' se side hereof, and agrees to install said pipes'
and/or a a es iaCdsti Ac Il 4rovisions of the Plumbing Code of the City ,
of Cupertino, and all other laws applicable thereto. ,
Use of Premises
In_ 'OwneC=! �1��� /Y .��. `- f 'Address
ra ' .ByW L.•.M1CXCY �OIvS;•.IMC:1= ;• Address
` O XcCT 0AGENT
Phone Sunnpvele, Cellt." ' APProv ✓
PLUMe1NG INSPECTOR `�
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