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LOT NO. 60 3
NO. STREET
APPLICATION FOR GAS PERMIT
CITY Or CUPERTINO
MAY 17 1563
Date—•�J 7 ' 196' Permit No. o7a 50
6-0
Pee $
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.
Use of Premises
Owner /�/4. ��-� -�y� v Address
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OFFICE
GAS SERVICE NOTICE corn
BUILDING INSPECTOR'S OFFICE
/ CITY OF CUPERTINO
/ o-
----- ----------------- ...._—._............. ., 196-
To
You are hereby author - to connect the G ,Service for
Owner or Tenant ..._z/.�.-./ _ _--___--
At-----------------------
1 New Service _.. ..._---------
No. of Meters -----.../......._.... Reconnect ......... -........ -...........
Move Service ........
No. of Add. Meters -------------- Move Meter ......-..........---......
----- ---
----- --- �_......... --
PLUMBING INSPECTOR
HO 7/61-500