2001 (2) i� C/� "� 7-� V/� v L.G�'P.�'�W _ •. _ LOT NO.
NO. BHT
AV9,11
FOR GAS PERMIT
i CF CUPERTINOAUG 3 0 1962
^�0 .!!Date 1,91(g—
9f"2— Permit No;
CITY OF .CUPERTINO Fee $ .,-d
Application is hereby made to the City of Cupertind for a permit to install gas pipes
"J and/or gas appliances as listed on the reverse side hereof, andyagrees'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.
h
Use of Premise
jag. Owne �� Lr4"'Address='Y�4
By Address G W
.I CONTRACTOR, AGHNT .� FtS.C` 4i•", '
Phone i✓�- -3!/Q7 `' pprove
� PLUMBING INSPECTOR
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Q�FICF
C(�"PY
GAS SERVICE NOTICE,
BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTINO w" .
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To
You
Tenanth ^r , GA
,
rF.
Yare hereby'autho' to conngt thee GA ice 4vm
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Owner
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• - / New Service sem........:....:
No:oF.Meterst,....:.l:...:....... Reconnect ..............................
ye'Service
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No. of Add. Meters ......... .. Move Meter .
PLUMBING INSPECTOR
110 7/61-500