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Q� - AI ATION FOR GAS PERMIT
z t AUG 21 963 . pCITY OF CUPERTINO
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° a Date-At � UkIrt4�rentn 1963 Permit NO.
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Application is hereby made to the City of Cupertino for a permit to install gas Pipes
`o a and/or gas appliances as listed on the reverse side hereof, and agrees to install said pipes
im` and/of appliances in accordance with the provisions of the Plumbing Code of the City
¢ m of Cupertino, and all other laws applicable thereto.
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aF State License Citi . 7 7�O U Approved
PLUMBING INSPECTOR
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