986 (2) 10-26-3
NO. STReeT +
LrATION FOR GAS PERMIT
® CITY OF CUPERTINO
DT � �,� 1960 195_ Permit No. 15-0
�n 'D
nn R{ Fee $ /,
v A�� lii;aiton (s h�Preffyi h'a �o the Cit of Cupertino for permit to install as pipes
Y P P 8 P Pe
and/or gas appliances as listed on the reverse side hereof• and agrees to install said pipes
r and/or appliances in accordance with the provisions of the Plumbing Code of the City
of Cupertino, and all other laws applicable thereto.
v
:i Use of Premises—
Ow n e r
remisesOwner /�9le lJ �^'� _
Address /
By s/n�— Address (l3T✓ i��IGrw VJ.
CONTRACTOR, AGENT
Phone_ �.1i " �Y 5' y Approved' ^
PLUMBING INSPECTOR
C1 z �fl In G) G) C1 L), :; w
� 'o ^ `e ❑ m w '^ p^ W rt 's'1 � N w X00 0.,
0
n
-- 9
0
za j --------------------
rt
z
T - ---- -- - ^ �
E ^
.moi