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1191 (2)Go N Co O ri �X d It 'L 3 53 A �Y A �A/ LOT NO. 65 NO. SUBST. Baywood Terrace t`APP;LICATION FOR APPLIANCE PERMIT J 01 CCI}Y OF. CUPERTINO AP's 5 ° `.'l Date )�F,_7 196..... Permit No. / (_ FeeS Application is hereby made to the City of Cupertino for a permit to install gas appliances as, listed on the reverse side hereof, and agrees to install said appliances in accordance with the provisions of the Plumbing bode of the City of Cupertino, and all other laws applicable thereto. Use of Premises Re s . P Address Box 634 _ Address Approve PLUMBING INSPECTOR EO �i