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NO, A STHrr.T
APIJ&IC'ATION FOR GAS PERMIT
i - CITY OF CUPERTINO
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211963
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a Date 196 Permit No.
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CITY OF URERM"mi) Per$ 1
Application is hereby made to the City of Cupertino for a permitto 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. PS
Use of Premises "L&DM.t o
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