453 (2) NO. IT BETS.
APR-!CATION FOR GAS PERMIT
CITY OF CUPERTINO
Date Permit No.��
*.' elo,
FeeAoth iof'Cu ertino fora rmit to,install" as Y P. pe g P Pe ...
L and/or gaz,appliancesras listed o. the.ieverse side hereof:-and agrees to:install;said.pipes; }yy
and/ona I es( ac�7,'{ T provisions ofrthe Plumbing Code.of the_City4-t.,,_
y of Caper ' and�7loth'€r'13ws applicable thereto L+'y vu
�t ,h s '.•"; r r t ...a:
. Use of Premises' .• s. . c'. :'r• (?v..r
W) Owner �¢LGI/J /%�/✓lQZ Address'
By 1 �` —Address
�!• 1- CONTRACMR`SA PNT i N
Phone ' ' c' O Bo: 7 1 I Approved
f,$UnnSr4ila' Calif. ; i t PLUMBING INSPECTOR
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