27870 Q
wZ
iiL//A-7Z LOT NO.�'o
FfAPR3rd
APPLICATION FOR GAS PERMIT
17 1964 IGIT7 OF CUPERTINO
Permit No.�7
Fee S --Z' 5—b
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.
Approved
PLUMBING INSPECTOR
of Appliance I Units Fees 11 New
MF.
mace
HOUSE GAS
Tested and