2049 (2) 1 `419 LOT NO,
NO. STR
® ��ltPIION FOR GAS PERMIT
;f CT '1 D 1962• .-
OF CUPERTINO
Date 6 ISm, e-. Permit No.
CITY OF. CUPERTINO Fee $ -Z
Application is hereby made 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. .
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a Use of Premisesci�4 ��T�a�A L., (�eQ
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in Owner J ' Address
By Address
,CONTRACTOR AGENT �
w Phone C/ �•'� `J a? ! Approtled
LUMa1NGINSPE OR �'
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NOWT`.� i 'STREET
APPLICATION FOR APPLIANCE PERMIT
ff�((FJAN 2,; 9863 CITY OF CUPERTINO
CIDate nl ^'•1'x:371:\'(` 196.3. Permit No.
1 1 1 a sin I
Fee 1
�a Application.is hereby made to the City of Cupertino for a permit to install
gas appliances assisted on-the reverse side hereof, and agrees to install said
appliances in accordance with the provisions of the Plumbing r-:ode of the City
u of Cupertino,,:nd all o er laws applicable t , eto. _
Use of Premises
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in Owner r Address _
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By Address
CONTRACTOR, AGP.NT
Phone Approved
r t ' ,PL mBING INSPECTOR
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