51064ICI
GAS SERVICE NOTICE OFFICE
_BUILDING INSPECTOR'S OFFICE
LU�I CITY OF CUPERTINO
---------/-----� 196..
T _ .
You are hereby authorized to connect the GAS service for
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Owner or Tenant ....: y ��C/. `.......-��
.............. - ----- ---------------
New Service ... ...............
No. of Meters /------------------- Reconnect
..........................
Move Service ........................
No, of Add. Meters .............. Move Meter ..........................
1.
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PLU BING INSPECTOR
O
NO. STREET
LOT NOS`--""' 14,�
APPLICATION FOR PLUMBING PERMIT
N a CITY OF CUPERTINO
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r o anitary No.
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o Date c�✓sue �v+ itld �e
U J ; J� t' 196 Permit No
_ LL Fee $
o Application is hereby made to the City of Cupertino for a permit to install plumbing
o ~ %pipe's./andr fipx�ttwtir'e^� sr Egnthe reverse side hereof, and agrees to install said ricer
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z and/or Wures ;n ac'6 ncei'H ith the provisions of the Plumbing Code of the Cfty of
w Cupertino, and all other laws applicable thereto.
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a Use of Premises
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F- 3 Owner X
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By J
CONTRACTO , AGENT
3 En Phone x� � r(� `j 37
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a o State License
Address
Address
Approved
PLUMBING INSPECTOR