1428 (2) �O�J IO J3 LOT NO.
NO. '� BTREE7�
^® ITI FOR GAS PERMIT
66T CUPERTINO
,,__ SEP `q g 1961
- I
N 1,
aDate .I _ Permit No. '
OF'✓CUPERTIN Fee $
1
App lication�js hereby madeto the ity of Cupertino for,a permit to install gasp Ts
4 I and/or app"I listed on the reverse side hereof, and agrees to install said pipes
9 and/or.a"ppliarices,in,accordance with the provisions of the Plumbing Code of the City
'1 'j of Cupertino;'�andiall other laws applicable thereto.
. � Use of Premises•,
u
0
Owner �r,+�..e�O,/_/ `.Q,o.✓awaAddre
O
By Addre
CONTq ACT00.� AGP.N
Appro.
�j
— one �f — �..;�'/// _
y ` PLUMBING INSP CT R
/( / { ) yc2o & /g
[® < | E4 ] \ » b \ \ }\
§ = , # ,
EJ2 \ I § ,2 �� (f (/\ � *& c§ � .
{{ / C
( \— & '® -------------- sass— . .
:2 �}
��� \ \ / -----------//
� \
t
{ \ -----------\\-\ \\w2c(\
a [ \