2147 (2) LOT NO, 3
NO. STREET yyam�,,
AAP. _IrICT�T QN FOR GAS PERMIT
CI OF CUPERTINO
01:3 7 4353 �,
Date 143 Permit No. <Z�/
CITY OF V IPERTINO Fees "o
Application is hereby made to the City of Cupertino for a 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.
Use of Premises
KINSPE6T
OwnerOAddress GAddressCONTRACTOR, AGENT ,Pbone"7?— 114/'2;7ApprovedPLUMB
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OFFICE
GAS SERVICE NOTICE corn
BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTINO
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......---.......- ` -/9_................., 196......
To You are herebyauth to conn - the GAS c
eQfor--7
Owner or Tenant ....: 6 / _..._....._......... ..
Atie... .9...9........ �... .._..............
' 4
New Service .....`...'.................
i ------No. of Meters ..... ............. Reconnect Move Service ........................
o
No. of Add. Meters ------.... .. n WLTM� Bjo ..*' NSPECTOR
-,1'10 7/61-500