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2232 (2) .. ,io,�a � ✓`. ., ' � LOTRNO No. STREET. APPLICATION';F.OR t " PERMIT 9 " ii,�• i,P?. CITY:OFfl CUPERTINOII�+,;. . Date Permit No. I '01" .Fee $ 5 a • Application is hereby made to the City of Cupertino.for,a,permit to install gas pipes r •s and/or gas appliances as listed on the reverse side hereof, and agrees to install said pipes {-sand/or appliances, iri accordance with the provisions of thet$lumbing Code of the City' l.. .b. �- of Cupertino, and all other laws applicable thereto. 7 Use of Premises I ►- A !tA k Owner ITU t ASi IA Address`I LJL � \t By wll�t3Q-�c�wJ�S _I_ LLi Address SIN CONTRACTOR, AGENT Phone G�— iI D l ti o-o Approved - V PLUG ING INSPECTOR R4 c.l :? c 2, w � - �fi' a 9 -a w 3• ^n � '� 'c7: '7y� �rtp rt -_ - 'O P. T :tl E � v rt g — —w Tr - - ----- m ^ A�