878 (2) He LOT NO. P.
® AP 01CATION FOR GAS PERMIT
fc�`] DEC •} 1959 CITY OF CUPERTINO
Date '� 195_S / Permit No.
CITY 0 UPERTINO Fees s_v
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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Useof Premises e ` Pf
W) Owner �O k�f P G u-( Address
By fr ��1,1y1Jfyof�+�u� Address SS� cne/as d
CONTRACTOR, AGP.NT
Phone RE'G-T�7¢ Approved
PLUMBING INSPECTOR
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'GAS SEEIC`E' NOTICE# `copir
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You are hereby authorized to connect th AS service for .
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Owner or Tenant ...... -------- .........:.
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. New Service ....
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No. of Meters :. ...... .. . _.-.Reconnect ..............................
Move Service .:................--..
No. of Add. Meters ..:...._:.. MoveMeter. ..:....................:..
PLUMBING INSPECTOR
110 6/59.500