487 (2) LOT NO. •X �,^_
. NO. LL s.RHET
2 2 48 APPLICATION FOR GAS PERIr11T
CITY OF CUPERTINO
R �yy
Date i 011q' ' 19 'a Permit No.
— !MAY 181959 Fee
Application is hereby made to the Ity of Cupertino for a permit to install gas pipes
1� and/or gaspRp c li q�je r�rse side hereof, and agrees to install said pipes
and/or ap l 1 Co ovisions of the Plumbing Code of the City-
:of Cupertino, and all other laws applicable thereto.
.' Use of Premises
7
Owner Address
���ll� Address
BvW. L-HICrKEY'cnntc 'wo-- Address -�
'P 40NLmACTO (�iGENT: ,
Phone Approve �c¢t
„2tP �� I ' _ _•.�+ -f PLUMBING INSPECTOR
C) z
_ v
O O
O ° n C a O m o v
n 'A
CZ
A
z
a
n N, .,
GAS; SERVICE NOS I E copiF.
BUILDING'INSPECTOR'SIOPTI E
i
Y:,.'CITY OF CUPERTINO"'""
r�
/ , !1 1
To
;You are hereby authorized to connect the GAS service for
Owner or Tenant ... . ....... ...:Ge%� 1,,.!!'.'
Ar7........ ..... _....
N ..........................
-..........
ew Service
`No. of Meters ....:..'. .......... Reconnect
MoveService '---'---------------
' . No. of Add. Meters ..........:... : -. . ,. Move Meter ;:.... ------_.._...... -
110 64-500. 5 ,
UMBING INSPECTOR'