1273 (2) /D • /tiC (a(✓94- LOT NO. 1
"°. STREaT Tract #2086
kPL'ICATION FGR APPLIANCE PERMIT
AP
w 10 7553 CITY OF CUPERTINO
Date,•-. . 6/17/63[! 196..... Permit No.
VI I r ur l;uNtKco
Fee $ 1 /
N Application is hereby made to the City of Cupertino for a permit to install
pgas appliances as.listed on the reverse side hereof, and agrees to install slid
r-i appliances in accordance with the provisions of the, Plumbing Code of the City
of Cupertino, and all,other laws applicable thereto. _
•uVj'`I Useof Premises Req
u
OwnelCU2ertino Prop. Ltd Address582 Market St. S.F.
SAN CARLOS SHEET METAL ORK -
PY Address
/1 SAN CAft}OS,1 ( fA^GBNr
Phone—_.YS s+� Approved WILLIAM D. BENEVICH
'lT2c l'✓ PLUMBING INSPECTOR
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