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LOT NO.µ1
NO. In T Baywood Terrace
C1� R APPLIANCE Pikuh 3110
OCT 11 1962 ioe�t% OF CUPERTINO
Date 196..... Permit No.
CITY DY-TUPERTINO Fee $ °
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
9 appliances in accordance with the provisions of the Plumbing r:ode.of the City
W of Cupertino, and all other laws applicable thereto. -
Use of Premises
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r7i Owner .Oar,4= i..rat• >"` +rt _ Address 'i0j AAk
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SAN CAQ,LyOS SHEET METAL WORKS, INC.
'7}yAq yRe"q Address
SN CARLOSRNyYyivAncBNr Approve
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