1076 a � 7
LOT NO.
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A,PPL � � TION FOR GAS PERMIT
�yQ CITY OF CUPERTINO
Date I ,1OG 9 11MINO 195_ Permit No. Z/)7
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Fee $_z
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.
Use of Premises_
14AMILY RESIDENCE
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A Owner Address �
By1QE AMARAI PLUMBING Address
. . 491j6RPREoALAb1M
Phone SANTA CLARA, CALIFORNIA Approved � wf G�
I PLUMBING INSPECTOR
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GAS SERVICE NOTICE
100r, rAlopy
BUILDING INSPECTOR'S OFFICE
CITY OF CUPERTINO/
.......................��&�
....................
To
You are hereby authip-rized to connect t AS service for
Owner or Tenant .........................
- ------------- ----------
.. ................. .... -------:..........
At/ ---**'**'*' 7*
New Service .--------- ...........
No. of Meters ..... ........... Reconnect .............................
Move Service ...................
No. of Add. Meters .............. Move Meter ..........................
................. . .... ..... ...............
. .........
�LUMBING INSPECTOR
110 1/60-500