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a LICATION FOR GAS PERMIT
DEC " by CITY OF CUPERTINO
r- 1959 Permit No. " " 0 _
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Application is hereby made to the City of Cupertino for a permit to install gas pipes
C and/or gas appliances as listed on the reverse side hereof• and agrees to install said pipe's
and/or appliances in accordance with the provisions of the Plumbing Code of the City
of Cupertino, and all other laws applicable thereto.
u
Use of Premises /�D Pf'
n Owner Jen Le J I rP!r Gel. p _ Address
ByJ �, Jhfl� /!l TJ c�
c.-., li'r aJ P� ,� Address -fm�. �' �• aJ
Phone /'PC- GNTT7>'GENW Approved��fo�/Cm
PLUMBING INSPECTOR
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A' : SERVICE NOT CE;� ' r)OFFICE
R IL ING INSPECTOR'S ONICE\ _' may , rGPti
CITY OP CUPERTINO
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.... .......:......./ 'al '.:'' ..............:..,
To
You are hereby authori�ed to conned the GAS se vice for
Owner or Tenant ..... .. .................
At
New Service
No. of Meters ...... ............. Reconnect ..............................
Move Service .............:..........
No. of Add. Meters .............. Move Meter ..........................
--------------- -- - - ..................
UMBING INSPECTOR,
110 6/59-500