110/0706 I. &.
LOT No. /
.c. •..NO. STREET.
•._�
APPLICATION FOR APPLIANCE PERMIT
11 OF CUPERTINO
DaMAR -2 �, 19C>..:.: Permit No.
ru
Fee a / !"—
tic 6n i Rif fthe City of Cupertino for a permit to install
gas I enc l`as liste on the reverse side hereof, and agrees to install said
ippliances in accordance with the provisions of the Plumbing bode of the City
of Cupertino, and all other laws applicable thereto.
Use of Piemises 64—? �a
_
DIVISION Milk, Address
NYOAKS AVE., CAMPBELL.1 i 'Apprlove PLUMBING INSettoa W
C
a
C
O
w
G
w im
T
OG
'�
ec'o
'O
rt
O
o.
C
GAS..SERVICE 1 ICE
BUILDING INSPECT' R S,OP,.ICT
CITY OF CUIPE IN
�% //
19
To
You are hereb .1 ❑razed to connect the GA ery ice for
�;• t--Oaner.or Tenant y... ------------ , 2C
t
Atr..a......_ .....:.:.... :.. ....................
New Service v
No. of Metcis ... Reconnect
n.. ............
I Move'Service .------.,..:.---....:,
No. of Add. Meters .:.:..:.......
Move Mel'cr ._....................... : .
..
PLUMBING INSPECTOR
v//
110 6/59-100. ..