894LOT'NO.
MEET_
APPLICATION FOR GAS PERMIT
OF CUPERTINO
'JAN 201960 Wj��j.%�
Date 195_ Permit No.�
CITY .OF. GUPERTINO. Fee $
Application is hereby made to the City of Cupertino for a permit to 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.
v
aPremises—/ Use of ��%�J �� �
n Owner Address
.I I
Address
Approved WILLIAM D. BENEVICH
PLUMBING INSPECTOR
I