475Qa'e •Ise- . a--_ LOT NO. /
NO. 570087 `
ip, Efc.J.
APPLICATION FOR GAS PERMIT
2 Z 48
CITY OF CUPERTINO
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Date- Permit No.��
+MAY 181959 . Fee
\ App tion 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 gp hce(1 a �c�i provisions of the Plumbing Code of the City
of Cuper Ino, and`vIaitl other laws applicable thereto.
Use of Premises LSC
'ryd
Owner,_
17i . Addresses `
.By P. O. Box 576 Address` CZE
SYa ffe6WkAC )IAGONT
;Phone Appioved
I i , PLUMBING INSPECTO
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