2070 (2) LOT NO. O
NO.. {BT
APPLI T FOR GAS PERMIT
;.,
ffNw 6 1962c 'F CUPERTINO
Date OCt. Permit No.
Fee 3
Application is hereby made to the City of Cupertino fora 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.
UseofPreons'es Residence L.
Own"er '' Det p Cliffe Dev. Co : 'Address Lo 10 rewo Ave.
$W 1. HICKEY SONS
/ Address °
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S ::PLUMBING INSPECTO
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GAS SERVIdE I0 ICE
BUILDING INSPECTPF�'S OFFICE
CITY OF CUPEIVINO
TO
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No. o ... ...... ... Reconnect ..............................
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No. of Add'.'Meters ........... Ydve� Meter ...................�:.j......
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B ING INSPECTOR
1O 7/61-500