2117 (2) �J 6
LOT NO.
NO. STRRF.T '
TI N FOR GAS PERMIT
W Z p I CUPLRTINO
rc
, 0 e/
0 Date "IDEC 11 19B2 qsd• Permit No. /
O App�it� a t ijy�ere�} y�rty of Cupertino for a permit to install gas pipes
o a and/or g'T r�j liadfes as"Ifst2d'Sn`th'e e'erse side hereof, and agrees to install'said pipes
> and/or appliances in accordance with the provisions of the Plumbing Code of the City
a m of Cupertino, and all other laws ap 'cable thereto. \
< � JJ LL Use of Premises
O O
3 Owner Address .
o By__ / — 'a'�--V Address
01,
— 0 Phone, �� 7- ����
Wt
oState License S Approved
—U I CONTRACTOR, AGRNT
CIO
-- \
c
§ §—\ ) � .
—�77r2y\\y2
-TI ; '\(
OFFICE
COPY
GAS SERVICE NOTICE
BUILDING INSPECTOR'S OFFICE
CITY OF COERTINO
................... ........ V. .................. 19Z....
To
You are hereby authorize connect the S service for
S�( C I service
.. ...... ............
Owner or Tenant --------------lz-�k---- - --- ------ . ... ......I...............
At.................. ........... =Tj
.- -......._.......r..-................
6�w Service ...._.."I...
No.
.......;---- ------
No. of Meters ......._Z.................... Reconnect ..............................
Move Se ice ------------------------
'C'
o..of M
-Add. Meters -------------- ......................
------------- ................... ....... .... ..........L
PLUMBING INSPECT
110 7/61-500