NO PERMIT NUMBER (2) f 'F I ( LOT NO.
STREET
l APPLICATION FOR GAS PERMIT-
CITY
CITY OF CUPERTINO
Date y 1960 � 95_ Permit No.
i
� Fee$
'- -'AplIilication is hererm de"to he�Cty of Cupertino for a permit to install.gas pipes
i
and/or gas appliances,as.aisle&oil;the reyeitse(side,.heSeof:and.agceeS: A�g's�ll�said pipes f� and/or appliances in accordance with the provisions of the Plumbing Code of the City
of Cupertino,'2rid-lall'other laws applicable thereto.
I -FAMILY RESIDENCE ."Use of Premises
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v, Owner Address. ,.--
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ddress•ByUE AMARAL P�11iLi Address
7,
Phone SANTA CIA�t
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IA Approved
PLUMBING INSPECTOR
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BC7/� - E R fEE;' b1tC0py
OF CIJPER //..,
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To
You are hereby authorized to connect the GGAS service for
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Owner or Tenant ..... ... ��� .������'...--•moi`-�
At...•1l 'ft = ......,..eA :-z ... .*- :...................................
New Service ... ...............•-
No.of Meters... ............... 4 Reconnect
Move Service ........................
No. of Add. Meters .............. Move Meter
• . _........:.........:.....� !.Last:...........................
/PLUMBING -INSPECTOR
Ito 1/60.300 - A '