1919 (2) LOT NO. .
NO. V STREET
jaAaAN FOR GAS-PERMIT
I
F UPERTINO
�1AUG ? 1`Q�,2
Date 19C-� Permit No.Z 919
/
CITY OF CUPERTINO Fee $
(� 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
`n and/or appliances in accordance with the provisions of the Plumbing Code of the City
of Cupertino, and all other laws applicable thereto.
_ 1 �. � Use of Premises
GT1in Owner i Address_ _
By I Address u
l CONTRACTOR, AGENT
Phone O/V 7—7 ee 7 2 Approved
i PLUMBING INSPECTOR
Gl z N h1 Gni G1 v'I G1 r'oe tp f7 G7. E w
c ooc ^ w o0
A a 9
w W o
------------
�
o T
T
Irl
Q
o _ w