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r'bl R APPLIANCE 'PERMIT
IMAY 24 1963 ;OF CUPERTINO
Date 19Cr.,,� Permit No.
CITY OF CUPERTIINO Fre $ soya
Application is hereby made to the City of Cupertino for a permit to install
gas appliances as listed on the reverse side hereof, and agrees to install said
appliances in accordance with the provisions of the Plumbing r',ode of the City
of Cupertino, and all other laws applicable thereto.
Use of Premises
r7i wner�-� Address-
Address f�
CONTRACTOR, AGENT - -L �,
Phone_ J�—y��3 t Approved_ /_�4GttJY/
Irl i , i I ;PLUMBING INSPECT
'• � die ,� � ' i R g � <. 3 a nno .w � 2 �' �I � .� �
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