51154�e
N Q
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ao
IT
Ic'G / LE151 LOT NO.
NO. STR'F
FeMITKATION FOR GAS PERMIT
GOF CUPFRTINO
CT l.0 1966
Uate 196_ Permit No.
CRY'U E t Fee S S
ph ton sUff ffid'e;tj the City of Cupertino for a permit to install gas pipes
and/or gas appliances asisthe 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 th^reto.
Use of
State
-95'r9S
INSPECTOR
l
of Aooliance I Units Fees 11 New
ME TYPE
HOUSE GAS PIPING
Number of Outlets Size of Main
Gas Piping Fees
Tested and Approved ......_. .............. ..............
DATE INSPECTOR